Could Sleep Apnea Cause Weight Gain? Understanding the Connection

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated episodes of partial or complete blockage of the upper airway during sleep, resulting in breathing pauses and frequent nighttime awakenings. Among the most common risk factors for developing obstructive sleep apnea is excess weight. When extra fat accumulates around the neck and upper airway, it can narrow the airway and increase resistance to airflow, making it more likely for breathing to be interrupted during sleep.

However, the relationship between sleep apnea and weight gain is complex and bidirectional. Not only does excess weight increase the risk of developing OSA, but having sleep apnea can also make it harder to maintain a healthy weight. Disrupted sleep quality caused by OSA can lead to hormonal changes that increase appetite and reduce feelings of fullness, making overeating and poor food choices more likely.

Poor sleep quality from obstructive sleep apnea also creates feelings of chronic fatigue, reducing motivation and ability to exercise, cutting off one of the most effective methods of weight loss.

This cycle can then lead to further weight gain, which in turn can exacerbate sleep apnea symptoms. Understanding this complex relationship is essential for anyone looking to both manage their body weight and improve their sleep quality.

• Sleep disruption from sleep apnea affects appetite-regulating hormones, increasing ghrelin and decreasing leptin, which leads to heightened hunger and potential weight gain.
• Daytime fatigue caused by sleep apnea reduces physical activity levels, creating a cycle that contributes to further weight gain and challenges in weight management.
• Effective treatment of sleep apnea, including CPAP therapy and oral devices, when combined with lifestyle changes, can help normalize hormonal levels and improve sleep quality, aiding in weight control.

Diagnosing sleep apnea starts with recognizing the symptoms, which often include loud snoring, excessive daytime sleepiness, and observed gasping/choking during sleep. Less well-known signs include morning dry mouth and multiple trips to pee during the night.

If you or a loved one is experiencing these signs, it’s important to seek answers. Traditionally, this meant visiting an in-person sleep lab. And while effective in identifying all types of sleep disorders, sleep labs tend to be expensive and suffer from long waiting lists. And of course, spending a night away from home asleep in a sleep lab is no one's idea of a good time.

Luckily, at-home sleep labs have made significant advancements and are highly effective in diagnosing clinical sleep apnea (and Daybreak provides one of the most convenient & affordable at-home sleep tests available anywhere).

A key measurement in diagnosing sleep apnea is the apnea-hypopnea index (AHI), which counts the number of breathing interruptions per hour of sleep. An AHI of 5 or more typically indicates obstructive sleep apnea, with higher numbers reflecting more severe disease. Accurate diagnosis is crucial, as untreated sleep apnea can lead to serious complications like cardiovascular disease, metabolic syndrome, and persistent excessive daytime sleepiness. Early detection and intervention can help prevent these health risks and start a virtuous weight-loss cycle.

The intricate dance between sleep and our body’s hormones is often taken for granted, until something disrupts it. Sleep apnea, particularly obstructive sleep apnea, throws this delicate balance into disarray, leading to significant changes in appetite-regulating hormones. Recent studies show that one of the most profound impacts of sleep apnea is on ghrelin and leptin levels, the hormones responsible for hunger and satiety, respectively.

Sleep deprivation caused by sleep apnea has been linked to an increase in ghrelin, the hormone that stimulates appetite, resulting in heightened hunger and cravings for high-calorie foods. At the same time, sleep apnea leads to decreased leptin levels, which diminishes feelings of fullness and can contribute to overeating.

In individuals with obesity, the hormone leptin is often elevated, which can result in leptin resistance, where the body no longer responds properly to satiety signals. This resistance, also commonly seen in sleep apnea, impairs the ability to feel full and further promotes overeating.

The combined effect of elevated ghrelin and lowered or resistant leptin levels can lead to increased appetite and potential weight gain. This hormonal imbalance is a double-edged sword, making it harder to resist food while also feeling less satisfied after eating. It’s a scenario where sleep-disordered breathing not only disrupts your nights but also significantly affects your days, driving a cycle of hunger, overeating, and weight gain.

Ghrelin: The Hunger Hormone

Ghrelin, often dubbed the “hunger hormone,” plays a crucial role in regulating appetite and hunger. In obstructive sleep apnea patients, levels of ghrelin are notably elevated, making individuals feel hungrier more often. This increase in hunger can lead to higher caloric intake, as individuals tend to consume more food overall, which not only contributes to weight gain but also further disrupts sleep patterns.

When ghrelin levels are high, it’s not uncommon for individuals to crave sugary treats or caffeinated drinks, especially when fatigue from sleep apnea sets in. This cycle of increased hunger, higher caloric intake, and poor food choices can quickly lead to significant weight gain, making the ongoing management of sleep apnea increasingly challenging.

Leptin: The Satiety Hormone

Leptin, known as the “satiety hormone,” signals to the brain when you’ve had enough to eat. However, sleep deprivation, a common consequence of sleep apnea, reduces leptin production. This reduction in leptin means that individuals feel less full after meals and are more likely to overeat. The hypothalamus, the brain region responsible for regulating appetite, is affected by this lack of sleep, leading to leptin resistance and diminished feelings of fullness.

Leptin resistance, compounded by sleep disruptions, creates a perfect storm for overeating and weight gain. As a result, individuals with sleep apnea are at a higher risk of gaining weight, which can further worsen their condition. With leptin levels chronically low, the body’s ability to regulate food intake is severely compromised, making weight management an uphill battle for those with obstructive sleep apnea.

Outside of hormone issues, daytime drowsiness from sleep apnea can lead to a significant reduction in physical activity levels. When you’re constantly fatigued, finding the energy and motivation to engage in regular exercise can become daunting. This lethargy creates a vicious cycle where lack of energy contributes to further weight gain. The lethargy associated with sleep apnea can hinder motivation to engage in physical activity, increasing the likelihood of weight gain and exacerbating the challenge of maintaining a healthy body weight.

Moreover, severe sleep apnea is often accompanied by daytime sleepiness, significantly impacting daily functioning. This persistent tiredness not only affects your ability to exercise but also reduces your overall activity levels, further contributing to weight gain and making weight control a challenging endeavor.

The metabolic dysregulation caused by sleep apnea is another critical factor contributing to apnea-driven weight gain. Insulin resistance is common among patients with obstructive sleep apnea, exacerbated by the distribution of body fat, particularly visceral fat. This condition makes it harder for the body to regulate glucose, leading to persistent hunger and increased fat storage. Nighttime breathing interruptions can elevate cortisol levels, a stress hormone that contributes to fat storage and increases the risk of obesity.

Research indicates that sleep apnea is associated with elevated inflammatory markers, which negatively impact glucose metabolism and increase the risk for metabolic disorders. These metabolic changes make it challenging for individuals to lose weight and maintain a healthy body weight, perpetuating a cycle of weight gain and worsening sleep apnea symptoms. Without significant weight loss, overweight subjects may face an increased risk of multiple health concerns, such as coronary artery disease, metabolic syndrome, insulin resistance & diabetes, stroke, hypertension, and other chronic conditions.

The quality of your sleep plays a pivotal role in weight control. Sleep apnea disrupts normal sleep quality, a key factor in regulating body weight. Multiple factors work in a vicious cycle of worsening apnea to further weight gain to worsening apnea.

• Elevated ghrelin levels due to sleep apnea lead to stronger cravings for high-calorie, sugary, and calorie dense foods. This disruption in sleep quality makes it difficult to maintain a healthy body weight, as the body is constantly fighting against hormonal imbalances that drive hunger and fat storage.
• Reduced Leptin levels in sleep apnea sufferers lead to lower levels of satiety. This, in turn, makes over-eating much more likely as the body struggles to recognize when it's time to stop.
• Energy levels are reduced because the body is unable to fully recover during the night when breathing is disrupted tens to hundreds of times a night as the airway constricts or collapses. Motivation and the ability to exercise consequently suffer.

In addition to weight gain, untreated sleep apnea can lead to other health risks, such as fatty liver disease, which is also associated with excessive weight. This combination of poor sleep quality and increased health risks underscores the importance of addressing sleep apnea for effective weight management.

Treating sleep apnea can be a crucial step in managing weight. The first step towards treatment is getting diagnosed. An at-home sleep study is a quick and easy way to get started.

If you’re diagnosed with sleep apnea, treatments such as oral device therapy can improve sleep quality, which is essential for effective weight management in individuals with sleep apnea. While studies indicate that treating sleep apnea does not consistently lead to weight loss, it can help with weight control by normalizing hormonal levels and improving sleep.

Weight loss is a key facet of managing both obesity and obstructive sleep apnea, as it can significantly reduce the severity of symptoms. Enhancing sleep quality and correcting hormonal imbalances through CPAP therapy and other sleep apnea treatment options can facilitate better weight management.

OSA Therapy and Weight Loss

OSA treatments such as oral devices, CPAP treatment, or other CPAP alternatives may contribute to weight loss and improve some metabolic abnormalities associated with OSA and obesity. Evidence from a randomized controlled trial supports the effectiveness of OSA therapies in improving weight and metabolic outcomes. The main benefits of treating OSA include reducing daytime sleepiness, improving quality of life, lowering blood pressure, reducing visceral fat, lowering total cholesterol, and increasing HDL. These improvements can make a significant difference in managing weight and overall health.

By addressing the root cause of sleep disruptions, OSA therapy can help individuals regain control over their appetite and energy levels, making it easier to maintain a healthy body weight. This holistic approach to treating sleep apnea can lead to better health outcomes and improved quality of life.

Lifestyle Changes and Sleep Apnea

Including nutrition in a weight loss strategy can greatly aid in managing sleep apnea symptoms. Changes in diet and exercise are pivotal in controlling these symptoms. Overweight patients, in particular, should focus on lifestyle changes such as weight loss and behavioral modifications to effectively manage sleep apnea. Regular exercise combined with a balanced diet contributes to weight loss, which can improve sleep apnea severity and overall health. Combining dietary changes and increased physical activity can provide a comprehensive approach to alleviating sleep apnea symptoms.

Healthy lifestyle habits can lessen the severity of sleep apnea symptoms and improve weight management. This proactive approach can lead to lasting improvements in both sleep quality and overall health.

GLP-1, Weight Loss, and Sleep Apnea

More recently, GLP-1 drugs have proven near-miraculous in their ability to drive significant weight loss. Significantly more weight, the FDA cleared Zepbound (tirzepatide) as a treatment for moderate and severe obstructive sleep apnea, and many insurance plans are beginning to cover its use as a result.

When combined with traditional treatment, such as an oral device or CPAP, even severe obstructive sleep apnea sufferers can expect to see a significant impact.

Weight loss is a powerful tool in reducing the severity of sleep apnea symptoms. Excess weight impacts sleep apnea by restricting airways, which can worsen symptoms. Studies have shown that individuals with sleep apnea tend to gain significantly more weight compared to those without the condition, highlighting the strong connection between sleep apnea and accelerated weight gain. Reducing the volume of fat in the tongue is linked to improvements in sleep apnea symptoms. Weight loss through diet, exercise, and/or medications has been hard to achieve and maintain, but it remains a crucial aspect of managing sleep apnea.

Focusing on weight loss can improve sleep apnea symptoms, overall health, and quality of life. This means that losing weight can become a virtuous cycle: losing excess body weight improves sleep apnea, which can, in turn, help reduce apnea-caused weight gain.

Moderate Weight Change and OSA Improvement

Moderate weight loss, even as little as 10%, can create beneficial changes in OSA patients. Moderately obese patients, in particular, can experience significant improvements in obstructive sleep apnoea (OSA) severity with moderate weight loss. The improvements in obstructive sleep apnoea severity resulting from moderate weight loss can have a positive impact on overall health and quality of life.

By making small, sustainable changes, individuals can achieve significant benefits in managing their sleep apnea and avoid making their sleep apnea symptoms worse.

Untreated sleep apnea can lead to serious health issues, including hypertension, cardiovascular disease, and diabetes. According to the American Diabetes Association, there is a strong link between obesity, diabetes, and sleep apnea, with research showing a high prevalence of obesity among those with sleep apnea. Chronic high blood pressure, a consequence of untreated sleep apnea, increases the risk for more severe cardiovascular issues like heart attack and stroke. Obesity elevates the risk of developing heart disease, lung issues, and diabetes, significantly complicating the effects of sleep apnea.

In summary, the connection between sleep apnea and weight gain is a complex interplay of hormonal imbalances, reduced energy levels, and metabolic dysregulation. Sleep problems, such as those caused by sleep apnea, can have a broad impact on overall health and well-being, affecting not only physical health but also mental health and daily functioning. Understanding how sleep apnea affects appetite hormones like ghrelin and leptin can explain why managing weight can be so challenging for those with this condition. Treating sleep apnea, whether through a custom oral device, continuous positive airway pressure (CPAP) therapy, or other CPAP alternatives, can significantly improve sleep quality and help in weight management. And remember, there are insurance options for sleep apnea that can help, including insurance for sleep apnea mouthguards!

By taking proactive steps to address sleep apnea and its impact on weight, individuals can improve their overall health and quality of life. As you embark on this journey, remember that small, consistent changes can lead to significant improvements in your health and well-being.

Can sleep apnea cause weight gain?

Yes, sleep apnea can cause weight gain by disrupting hormones that control hunger and satiety, reducing energy levels, and leading to metabolic issues. Clinically, obstructive sleep apnea syndrome is associated with weight gain due to its impact on metabolic regulation and increased risk of obesity.

How does treating sleep apnea help with weight management?

Treating sleep apnea enhances sleep quality and balances hormones, which can lead to increased energy levels and better weight management. Consulting a sleep med specialist can provide comprehensive treatment for both sleep apnea and weight management. This holistic approach facilitates easier adherence to healthy habits.

What are the benefits of Oral Device Therapy for sleep apnea patients?

Oral Device Therapy significantly enhances the quality of life for sleep apnea patients by reducing daytime sleepiness and improving overall health metrics, such as blood pressure and cholesterol levels. As part of a comprehensive range of sleep solutions, oral device therapy offers an effective, tailored approach to managing sleep apnea. This treatment also contributes to better metabolic health by reducing visceral fat.

Can weight loss improve sleep apnea symptoms?

Yes, weight loss can significantly improve sleep apnea symptoms by reducing upper airway restriction and enhancing overall health. Weight loss positively affects upper airway anatomy by decreasing fat deposits around the airway, which reduces airway collapsibility and helps alleviate sleep apnea symptoms.

Can GLP-1s (Ozempic, Wegovy, Mounjaro, Zepbound) help with Sleep Apnea?

Yes, because weight gain can cause or worsen sleep apnea, losing weight with the help of a GLP-1 class drug can also help alleviate sleep apnea, and the FDA recently cleared Zepbound (tirzepatide) for just this use case.