The Relationship Between Obesity & Obstructive Sleep Apnea
by Dr. Scott Bolding
Obesity is a common disease in the US. It’s estimated that 93 million Americans are affected by obesity. Unfortunately, obesity can cause a number of health problems. The most common conditions that are caused by obesity include type 2 diabetes, hypertension, and heart disease.
There is also a link between obesity and sleep apnea. Sleep apnea and obesity have an interesting relationship. On the one hand, obesity increases the risk of developing this sleep disorder. At the same time, sleep apnea can increase weight gain, leading to obesity.
Because obesity and sleep apnea are linked, losing weight can help treat OSA. Sleep apnea, however, is a complicated disease. There are usually multiple factors at play. For most people losing weight is helpful but will not cure sleep apnea completely.
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What is Obesity
Before we dive deeper into the relationship between obesity and sleep apnea, let’s take a look at what obesity actually is. Obesity is when you have excess body fat. When your body takes in more calories than you burn throughout the day, it stores those calories as fat. Over time, this fat builds up in your body.
Obesity is diagnosed using the body mass index, or BMI. This tool uses your weight in pounds multiplied by 703, divided by your height, and then divided by your height again. Then, based on the score you are diagnosed as underweight, normal, overweight, or obese. Obesity is diagnosed when you have a score over 30.
Of course, BMI is not a perfect diagnostic tool. Some people who have a lot of muscle mass may have a higher BMI but are not considered obese. Obesity has more to do with the amount of fat in your body than anything else.
Obesity can have a massive impact on your life. It can put you at greater risk of a lot of health problems including:
- Heart disease
- High blood pressure
- Type 2 diabetes
- Certain cancers
The causes of obesity can vary. Some people are more prone to becoming obese due to genetics and hormones. However, the most common causes of obesity are behavioral and lifestyle choices. Unhealthy diets and a lack of exercise keep calorie intake high without burning any of it off. The Western lifestyle, with an abundance of fast food and jobs that keep us sitting all day, lends itself to increased obesity.
Therefore, for most people, the best way to cure obesity is with exercise and changes to your diet.
What is Sleep Apnea
Now let’s look at what sleep apnea is.
Sleep apnea is a disorder where your breathing is interrupted while you sleep. When you sleep the muscles in the back of your throat relax. Most people breathe just fine when this happens. However, some people’s airways collapse, blocking the airway and making it difficult for air to get through. This collapse causes what’s known as obstructive sleep apnea (OSA).
When your airway collapses your brain senses you’re not getting enough air. So it wakes your body up just enough to reopen the airway. This is known as an apnea event. These apneas happen frequently throughout the night, constantly disrupting your sleep. However, you usually don’t notice when they happen because they’re so brief.
How Are Obesity and Sleep Apnea Related?
As we’ve noted already, obesity and sleep apnea have an interesting relationship. Obesity is one of the most common risk factors for sleep apnea. This has to do with how weight affects your upper airway and chest. Your risk of developing OSA increases with your BMI score. A weight gain of even 10% increases your risk of sleep apnea 6 times. Roughly 60 – 90% of adults with OSA are also obese.
Sleep apnea can also make it harder to lose weight, often leading to obesity.
So, obesity causes sleep apnea. And sleep apnea can cause obesity. Understanding this relationship is crucial for treating both conditions.
How Does Obesity Cause Sleep Apnea?
First, let’s look at how obesity causes sleep apnea.
Obesity puts you at risk of developing a number of health conditions. Obstructive sleep apnea is one of them. Obesity happens when your body turns excess calories into fat. This fat is stored in different places in your body. For example, fat deposits are often stored in the neck and chest. This is especially common for men.
The fat deposits in your neck, known as pharyngeal fat, affect the size of your upper airway. And when you lay down this fat falls back blocking the airway. Your body has to disrupt your sleep in order to breathe again.
Fat can also develop on the chest. This excess weight pushes against your chest, decreasing your lung capacity. Reduced lung capacity makes it easier for your airway to collapse. This is known as obesity hypoventilation syndrome. 90% of people with this condition also have sleep apnea.
Sleep Apnea Causes Weight Gain
On the flip side, sleep apnea can also lead to weight gain.
The main side effect of sleep apnea is sleep deprivation. Sleep deprivation causes many problems including daytime sleepiness, irritability, and memory problems. It also leads to a lack of energy. When you’re tired it’s harder to motivate yourself to exercise and eat well. And as we’ve already discussed, eating more than you’re moving is the main cause of weight gain.
The sleep deprivation brought on by OSA can also impact your hormones as well. The hormones that control your appetite are specifically affected. Leptin, the hormone that suppresses your appetite, decreases. And ghrelin, the hormone that stimulates your appetite increases.
So, if you have sleep apnea you may not feel like working out. But your cravings for food increase due to a hormonal imbalance.
For a lot of patients, this turns into a vicious circle. Their obesity causes sleep apnea, but then sleep apnea makes it hard to lose weight. And that just exasperates the problem.
How Obesity and Sleep Apnea Affect Your Health
Both obesity and sleep apnea are dangerous all on their own. They each cause their own set of health problems. But it all gets worse when they’re combined.
Obesity and sleep apnea can both affect your cardiovascular health. With sleep apnea, your body’s oxygen supply drops. This raises your blood pressure and heart rate. Both of these increase your risk of having a heart attack or stroke. Obesity also increases your risk of heart problems all on its own.
Both sleep apnea and obesity are also risk factors for metabolic and pulmonary problems as well.
Does Losing Weight Cure Sleep Apnea?
The impact that both sleep apnea and obesity can have on your health makes it critical to treat both conditions. And since they can cause each other, treating both conditions at the same time is the best strategy.
Losing weight alone is an important part of your overall treatment plan. Weight loss decreases the fat in your neck and chest, naturally opening up your airway. It’s not always an easy process, but with the right medical team by your side, you can accomplish your goals. Basic lifestyle adjustments like working out and changing your diet are small steps that go a long way.
Weight loss alone won’t cure your sleep apnea in most cases, however. You still need to treat sleep apnea head-on. Sleep apnea is a complicated condition, often with several factors at play. We need to address every aspect of your OSA in order to see real results.
Along with weight loss, treatments for sleep apnea include:
By treating sleep apnea at its roots we can help you get better sleep, leading to more energy, which in turn will make losing weight that much easier.
Obesity – Symptoms and causes. (2021, September 2). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
Obesity Action Coalition. (2018, June 12). Obesity Statistics. https://www.obesityaction.org/get-educated/public-resources/obesity-statistics-fact-sheets/
Pacheco, D. (2023, January 6). How Weight Affects Sleep Apnea. Sleep Foundation. https://www.sleepfoundation.org/sleep-apnea/weight-loss-and-sleep-apnea
Obesity and Sleep Apnea
An Interesting Relationship
Obesity and sleep apnea have an interesting relationship. On the one hand, sleep apnea is often caused by excess weight. But sleep apnea can also increase weight gain.
Because how sleep apnea and obesity are linked, losing weight is an essential part of treating OSA. However, you can’t depend on losing weight alone. If you want to get the sleep you need, you need to treat sleep apnea head-on.