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Is Sleep Apnea Reversible With Weight Loss?

Written on September 13, 2023 by Amy Harris, MPH, RN. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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When it comes to your health, sleep may be just as important as what you eat, how much you exercise, or even your genes. Getting adequate quality sleep is critical for your cognitive function and mental, cardiovascular, and metabolic health.[1] If a healthcare provider diagnosed you with a type of sleep disorder called obstructive sleep apnea (OAS), losing some weight may be a treatment option. Keep reading to learn more about the potentially reversible relationship between sleep apnea and weight loss.

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What Is Sleep Apnea?

Sleep apnea is a common disorder in which you stop and restart breathing while you sleep. In obstructive sleep apnea (OSA), the most common type of sleep apnea, a narrow or blocked upper airway (your throat) disrupts breathing.[1,2,3]

This irregular breathing pattern prevents your body from getting enough oxygen, disrupts your sleep cycles, and can harm your health.[4]

Your age, family history, lifestyle habits, other medical conditions, and some body features can raise your risk of sleep apnea.[1]

How Is Body Weight Related To Sleep Apnea?

Sometimes it seems like “it’s complicated” is the answer to every question these days, but the relationship is not so simple when it comes to weight loss and sleep apnea.[5] There are different ways to treat sleep apnea, including maintaining a healthy weight. However, there is no cure for sleep apnea.[2]

What makes the relationship between weight and sleep apnea complicated? First, there are many different reasons why you keep waking up at night. If apnea is not the cause of your sleep problems, then weight loss might not help.

Second, there are different causes of sleep apnea. Only one, obstructive sleep apnea (OSA), may be improved or reversed by losing weight.[1,2,3] Suppose you have had a sleep study (possibly a home-based sleep study) to diagnose your type of sleep apnea. In that case, most likely, your healthcare provider or sleep specialist has talked with you about whether or not weight loss is a recommended treatment option.

The most common risk factor for OSA is obesity. Obesity means having too much body fat,[5] defined by healthcare providers as having a body mass index (BMI) of 30 or above. People with this condition can have increased fat deposits in their necks that can block the upper airway.[1] Not only can excess weight cause sleep apnea, but it can worsen the symptoms. Insufficient sleep may also lead to weight gain, making it a vicious cycle.[6]

Research has shown that losing just 10% of your body weight can improve sleep apnea when overweight or obese.[2] So, if you have OSA, weigh 200 pounds, and lose 20 pounds (10% of 200), your sleep apnea may improve. Other studies show that this amount of weight loss (10% to 15% of total body weight) improves how severe sleep apnea is (the number of times you wake up per night, for example) but does not entirely cure it.[5]

For example, a small study of 89 overweight or obese men with moderate to severe OSA found that weight loss and lifestyle modifications significantly improved OSA severity after eight weeks.[7] At six months, nearly two out of every three patients (62%) who underwent weight loss and lifestyle changes no longer required CPAP therapy. Continuous positive airway pressure (CPAP) therapy is the first-line (non-surgical) treatment for obstructive sleep apnea.[7]

Just like weight loss, CPAP can’t cure sleep apnea. But, it can reduce apnea to the point where it stops happening or isn’t severe enough to cause symptoms.[2]

Sometimes reaching a healthy BMI through weight loss can reverse sleep apnea, but your OSA may reappear if you regain that weight.[3,9] In this sense, the reversal of sleep apnea through weight loss is not permanent.

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How Much Weight Do You Need To Lose To Reverse Sleep Apnea?

If you are overweight or obese and have obstructive sleep apnea, your healthcare provider will likely encourage you to make lifelong heart-healthy lifestyle changes. These include getting regular physical activity, maintaining healthy sleeping habits and a healthy weight, limiting alcohol, and quitting smoking.[1,10] Even though losing weight and reaching a healthy BMI won’t cure your sleep apnea, it may take care of your symptoms, give you and your sleeping partner a full, uninterrupted sleep, and allow you to stop using a CPAP machine.

The exact amount of weight you need to lose to have this “reversal” or reduction in OSA symptoms depends on several factors, such as:

  • What weight you can successfully maintain over the long term (longer than ten years) without weight cycling[11,12]
  • Other medical conditions you might have, such as hypothyroidism, heart disease, or diabetes
  • Your level of physical activity (how much and how often you exercise)[12]

Losing weight can help you manage other chronic diseases (like heart disease, high blood pressure, and type 2 diabetes) — not just sleep apnea.[9] Maintaining a healthy weight can also help reduce your risk of developing these diseases if you do not already have them.[10]

A healthy weight loss goal for most people is to lose one to two pounds weekly. People have more success maintaining a lifelong healthy weight when participating in a complete lifestyle intervention program with a restricted calorie diet, increased physical activity, and behavioral therapy.[10]

On average, total caloric intake should be limited to 1200 to 1500 calories per day for females and 1500 to 1800 calories for males for at least six months for safe and effective weight loss.[10]

Everlywell Can Support You On Your Weight Management Journey

Losing weight and keeping it off for the long term is hard work. Don’t go it alone. You can increase your weight loss chances of success through a healthy partnership with Everlywell, via the telehealth option for weight loss help online.

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References

  1. What is sleep apnea? National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/sleep-apnea. Accessed August 19, 2023.
  2. Sleep apnea: What it is, causes, symptoms & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea. Accessed August 19, 2023.
  3. Sleep apnea. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631. Published April 6, 2023. Accessed August 19, 2023.
  4. Harris E. How Sleep Apnea Contributes to Cardiovascular Disease. JAMA. https://pubmed.ncbi.nlm.nih.gov/37585179/. Published online August 16, 2023.
  5. Patel SR. The complex relationship between weight and sleep apnoea. Thorax. 2015;70(3):205-6. https://pubmed.ncbi.nlm.nih.gov/25487572/.
  6. Obesity. MedlinePlus. NLM. https://medlineplus.gov/obesity.html. Accessed August 18, 2023.
  7. Carneiro-Barrera A, Amaro-Gahete FJ, Guillén-Riquelme A, Jurado-Fasoli L, Sáez-Roca G, Martín-Carrasco C, Buela-Casal G, Ruiz JR. Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention on Obstructive Sleep Apnea Severity: The INTERAPNEA Randomized Clinical Trial. JAMA Netw Open. 2022 Apr 1;5(4):e228212. doi: 10.1001/jamanetworkopen.2022.8212. PMID: 35452108; PMCID: PMC9034401.
  8. Cooper CB, Neufeld EV, Dolezal BA, Martin JL. Sleep deprivation and obesity in adults: a brief narrative review. BMJ Open Sport Exerc Med. 2018 Oct 4;4(1):e000392. doi: 10.1136/bmjsem-2018-000392. PMID: 30364557.
  9. Araghi MH, Chen YF, Jagielski A, Choudhury S, Banerjee D, Hussain S, Thomas GN, Taheri S. Effectiveness of lifestyle interventions on obstructive sleep apnea (OSA): systematic review and meta-analysis. Sleep. 2013 Oct 1;36(10):1553-62, 1562A-1562E. doi: 10.5665/sleep.3056. PMID: 24082315; PMCID: PMC3773205.
  10. Losing weight: Getting started. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/losing_weight/getting_started.html. June 3, 2022. Accessed April 18, 2023.
  11. Haase CL, Lopes S, Olsen AH, Satylganova A, Schnecke V, McEwan P. Weight loss and risk reduction of obesity-related outcomes in 0.5 million people: evidence from a UK primary care database. Int J Obes (Lond). 2021 Jun;45(6):1249-1258.
  12. Nilsson PM, Is Weight Loss Beneficial for Reduction of Morbidity and Mortality?: What is the controversy about?. Diabetes Care 2008 February; 31 (Supplement_2): S278–S283.
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