A diagnosis of obstructive sleep apnea syndrome can mean a lot of unexpected changes for your body like weight gain that may develop into other medical conditions and symptoms that you didn't have before. It can increase your risk factor for type 2 diabetes, high blood pressure (hypertension) and may even cause heart attacks. Obstructive sleep apnea can also cause you to gain excess weight which can worsen your sleep apnea symptoms. With certain lifestyle modifications, you can lose weight and improve your sleep apnea symptoms in conjunction with CPAP therapy.
Obstructive Sleep Apnea and Weight Gain
Obstructive sleep apnea is a sleep disorder that happens when the upper airway is narrow or blocked, causing an obstruction and it can seem like the person is breathing through a straw at night. This causes the person to wake up suddenly or not be able to sleep at all. The person will be extremely tired during the day which is a symptom of sleep apnea called daytime sleepiness. Daytime sleepiness can cause problems with staying awake and focusing during the day.
Sleep deprivation can increase ghrelin levels which is an appetite-stimulating hormone and it can decrease leptin levels which is an appetite-suppressing hormone, therefore, causing you to eat more calorie-dense foods. Inadequate sleep has been proven to cause overeating, a decrease in fat loss, and can even cause obesity. Obstructive sleep apnea patients are at a higher risk for weight gain than someone with the same BMI (body mass index) and health conditions. One study, in particular, showed that OSA patients gained 16 pounds more than someone with the same BMI but who did not suffer from OSA.
Excess body weight can increase neck circumference and cause obstructive sleep apnea by creating fat deposits in a person's neck called pharyngeal fat. Pharyngeal fat can block the upper airway during sleep and cause an obstruction or cause the person to snore. Increased abdominal circumference from excess weight can lead to a person's chest wall being compressed, decreasing their lung volume. Decreased lung volume can diminish airflow which in turn causes the upper airway to collapse during sleep. It is important to mention that not everyone who is overweight will develop sleep apnea but being overweight may worsen sleep apnea symptoms in some people.
Other contributing factors to obstructive sleep apnea syndrome are enlarged tonsils that can cause airway obstructions or certain jaw shapes and facial constructs that may be misaligned which can cause an irregular breathing pattern or obstructions.
Sleep Apnea Symptoms and Health Effects
Daytime sleepiness is a sleep apnea symptom that can hinder your attempt to lose weight. Since you are not getting proper sleep at night, you may be extremely tired and lethargic during the day causing you to exert less physical activity during the day. This can lead to even more weight gain since you are not doing any physical activity which can increase ghrelin levels causing you to crave calorie-dense food.
For obese patients, this can be especially problematic since they tend to experience shortness of breath, and chest discomfort from participating in physical activities which can lead to them avoiding physical activity altogether and gaining more weight which in turn increases the risk factor of developing severe OSA. Daytime sleepiness can also put you at higher risk for car crashes. Since you are tired during the day from not getting enough sleep at night, there is a chance that you can fall asleep at the wheel and cause an accident.
Obstructive sleep apnea may cause other health conditions since insufficient sleep can put added stress on the pulmonary, cardiovascular, and metabolic systems. When an obstruction happens, it triggers the "flight or fight" response. This causes the person's heart rate and blood pressure to increase which then causes the person to wake up to reopen their airway. This vicious cycle of rising and falling blood oxygen levels can create a build-up of plaque in the blood vessels called atherosclerosis. This plaque build-up can cause cardiovascular disease.
OSA causes elevated carbon monoxide and glucose levels in the blood, increases insulin resistance, and alters the part of the nervous system that controls heartbeat and blood flow. These things can lead to Type 2 diabetes, heart disease, hypertension, and even strokes.
Will Losing Weight help with my Sleep Apnea Symptoms?
Weight loss can help significantly reduce obstructive sleep apnea symptoms. Weight loss reduces neck circumference which in turn reduces fatty deposits in the neck and tongue that contributed to airflow restrictions. Reduced abdominal fat increases lung volume and improves airway traction making it less likely for an airway collapse. Weight loss can also reduce sleep apnea symptoms such as daytime sleepiness and show an improvement in insulin resistance, cardiovascular health, and Type 2 diabetes.
Weight loss of just 10-15% can reduce severe sleep apnea by 50%, especially in obese patients. Your sleep medicine doctor is going to prescribe dietary restrictions and exercise as the first-line treatment for obesity. Getting your weight down to a healthy range for your body type is very important in treating sleep apnea. Medical advice suggests that behavior modifications and dietary restrictions are key in losing weight and reducing your sleep apnea symptoms as well as physical activity.
Behavior modifications like increased physical activity and a healthy diet are just as effective as surgery in improving OSA symptoms. Eating a well-balanced diet can give you more energy and boost your metabolism. Exercise can significantly improve the severity of sleep apnea symptoms without a pronounced amount of weight loss. Continuous positive airway pressure or CPAP therapy with a CPAP machine is an effective sleep apnea treatment option and may help you lose weight as well as decrease your apnea-hypopnea index. I should mention, however, that long-term CPAP use has been linked to weight gain as a side effect in some studies while others claim that you can lose weight but further research is needed to find out why these results contrast each other.
If you are using CPAP therapy to treat your sleep apnea it is very important that you use it daily. A study was done by Dr. Jonathan Jun, an assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore which monitored 31 obese patients with sleep apnea.
Some were monitored while using CPAP therapy and the other group had not used CPAP therapy in 2 days. The participant's brain waves, blood oxygen levels, heart rates, breathing, and eye and le movements were monitored. Blood was also drawn from the participants every 20 minutes, starting at 9 PM and ending at 6:40 AM. This study showed that the group who had not used CPAP for 2 days had increased levels of fatty acids in the blood, increased insulin levels, elevated heart rate, and increased cortisol levels which is a stress hormone. Cortisol levels are controlled by the HPA axis which also controls sleep cycles. When the HPA axis is disrupted it can lead to insomnia.
Dr. Jun concluded that while these things may not be directly linked to sleep apnea since his subjects were overweight, the study definitely showed that sleep apnea can worsen any health conditions a person may have. It also showed that missing even 2 days of CPAP therapy can cause sleep apnea symptoms to worsen.
Final Thoughts
Reaching a healthy weight for your body mass is crucial in reducing your sleep apnea symptoms. A weight loss program may benefit someone who needs a little extra motivation to get up and eat healthily and exercise. Losing weight may also improve your sleep quality which may improve your AHI index and sleep study results. Weight loss can even reduce your central sleep apnea symptoms as well. It is very important that you maintain a daily CPAP therapy regimen and develop healthy habits to improve your sleep apnea symptoms and your overall quality of life. Don't forget to visit Sleeplay.com for all your CPAP equipment needs!
