Why does sleep apnea cause weight gain?

Getting good sleep is extremely important for our health. Both poor quality and short sleep duration have been linked to many adverse health outcomes, including excess body weight.  Sleep apnea is one sleep disorder that can cause poor sleep and has been associated with weight gain. Unfortunately it is a vicious cycle because weight gain can worsen sleep apnea. Keep reading to learn more about the relationship between sleep apnea and weight gain.

What is sleep apnea?

Sleep apnea is a potentially serious condition in which you stop breathing or have shallow breathing (apnea) for periods of time while sleeping. This can lead to significant health problems such as high blood pressure, abnormal heart rhythm, heart attack, and stroke. Studies show that severe sleep apnea significantly increases the risk for sudden cardiac death, so diagnosis and treatment is extremely important for your health. 

3 Types of sleep apnea

There are three types of sleep apnea - central, obstructive, and complex. Central sleep apnea is when the brain doesn’t tell your muscles to breathe. This type of apnea is often associated with a serious illness or a side effect of medications. Obstructive sleep apnea (OSA) is the most common type of sleep apnea, affecting nearly 30 million Americans. In OSA, there is a partial or complete blockage of the airway during sleep leading to symptoms such as snoring, choking, or gasping for air. This interrupts sleep and can cause symptoms during the day. Those symptoms include headaches, fatigue, easily falling asleep while doing other tasks, memory issues, and weight gain. Complex sleep apnea is a combination of central and obstructive sleep apnea. Given that OSA is the most common form of sleep apnea, that will be the focus of this article.

Risk factors for sleep apnea

Risk factors for obstructive sleep apnea include male gender, older age, having a large neck circumference, smoking, and the use of alcohol or sedatives. Excess body weight also appears to be one of the most significant risk factors for developing sleep apnea.

What is the relationship between sleep apnea and weight gain?

The relationship between sleep apnea and weight goes both ways - having sleep apnea can lead to weight gain and weight gain can lead to sleep apnea. It is estimated that about 70% of persons with sleep apnea have obesity. Studies confirm that the risk of developing sleep apnea increases with weight gain. It also appears that the severity of sleep apnea worsens with increasing body weight. The reason for this relationship between excess body weight and the development of sleep apnea isn’t fully understood. It is most likely secondary to fat accumulation in the neck leading to narrowing of the airway and increasing the likelihood for obstruction during sleep. 

Sleep apnea may also cause weight gain. Some studies have shown a period of excessive weight gain just prior to sleep apnea diagnosis. This is likely due to the disruption in sleep that sleep apnea causes leading to fatigue, increased appetite and cravings, and hormonal changes known to affect body weight. 

How does sleep apnea cause weight gain?

Poor sleep adversely impacts health in a number of ways, including our weight. Studies have shown that sleeping less than 7 hours per night is associated with weight gain and the development of obesity. Sleep apnea is a condition that decreases the duration and quality of sleep, so it’s not surprising that it can also contribute to weight gain. This is thought to occur for a few reasons: 

• Fatigue - One of the most common symptoms of sleep apnea is daytime sleepiness. This can lead to falling asleep during activities of daily life and, understandably, a lack of interest in participating in physical activity.

• Increased Appetite and Cravings - Studies show that poor sleep, as is the case with sleep apnea, can lead to an increase in appetite and cravings for high-carbohydrate foods. This can lead to increased caloric intake and weight gain. 

• Hormonal Changes - Some of the hormones involved in appetite regulation and metabolism are affected by sleep apnea including insulin, leptin, and ghrelin. 

• Insulin - Sleep apnea increases the likelihood of insulin resistance, a condition often associated with excess body weight and diabetes. Insulin resistance can promote weight gain because insulin is a hormone that tells our body to store fat and it makes us feel hungrier, thereby increasing food intake. 

• Leptin - Leptin levels are elevated in persons with sleep apnea. While leptin is a hormone typically associated with weight loss, the elevated level suggests that sleep apnea may be associated with leptin resistance, a state where the body is less responsive to the weight loss effects of this hormone. 

• Ghrelin - Ghrelin, also known as the “hunger hormone”, is elevated in persons with sleep apnea. This could be why they experience an increase in their appetite, which would lead to increased food intake and weight gain. 

Would treating sleep apnea help you lose weight?

There are many benefits to treating sleep apnea, but for many patients the most noticeable benefit is feeling more rested and energetic. Patients often describe treatment as life-changing and can’t imagine not using their CPAP (continuous positive airway pressure machine used to treat sleep apnea) while they sleep. The research is not conclusive on whether or not treating sleep apnea helps you to lose weight. However, there is research that has shown that persons treating their sleep apnea with CPAP therapy increased their physical activity level after starting treatment; by an amount that was meaningful for improving health. 

Changes in Gherlin and Leptin

Additionally, there are changes in ghrelin and leptin levels immediately after starting sleep apnea treatment. It is likely these hormonal changes will help with appetite control, allowing someone with sleep apnea to more easily stick to a healthful, reduced-calorie diet. This in combination with increased physical activity could certainly help with weight loss. 

Would losing weight help with your sleep apnea symptoms?

Absolutely! Weight loss is one of the first recommended treatments for persons diagnosed with sleep apnea. Research confirms that losing even 10% of your body weight can reduce the severity of sleep apnea. And there have been studies showing that many patients see a complete resolution of their sleep apnea after bariatric surgery.  With that said, your sleep apnea may still require treatment such as CPAP therapy after weight loss, so continuing to see your healthcare provider to ensure your sleep apnea is adequately treated is important for preventing serious complications. 

How Form Health can help with sleep apnea and weight gain

At Form Health, all patients are paired with a Board Certified Physician who will complete a thorough initial evaluation that includes screening for sleep apnea. Form providers have expertise in weight management and will provide patients with a personalized weight loss path that can assist them with losing weight and improving their sleep apnea as well as other health concerns. 

If you’re interested in seeking medical care for weight management and working with experts to develop a personalized path that will improve your sleep apnea and help you lose weight, give Form Health a try! Our insurance-covered medical weight loss program uses tools like behavioral support, nutrition, physical activity, and FDA-approved medication, if appropriate, as parts of a comprehensive weight loss program to help you lose weight and improve your health.

If you’d like to get back on track, take our quiz to see if the Form Health program is right for you!