Sleep apnea and obesity: What’s the connection?

While people of all shapes and sizes can be diagnosed with obstructive sleep apnea (OSA), obesity seems to be an underlying risk factor. But just how much does obesity affect OSA and can losing weight cure it? We’ve taken a look at the research to find the connection between sleep apnea and obesity.

The relationship between sleep apnea and weight gain

OSA and weight gain appear to have a somewhat cyclical relationship. Studies have demonstrated that obesity increases the risks of developing OSA and that losing weight may help reduce the risk of developing sleep apnea. At the same time, treating sleep apnea may help stimulate weight loss.

“There is evidence that treating obesity reduces the severity of obstructive sleep apnea and that treating obstructive sleep apnea decreases obesity, ” a 2009 study published in Clinics in Chest Medicine concluded.¹

OSA is often treated with a continuous positive airway pressure (CPAP) therapy, which is considered the “gold standard” of sleep apnea treatment. CPAP uses airflow to keep the airways open during sleep. Given how intertwined obesity and sleep apnea are, truly effective treatment may require a broader approach. A 2012 study published in Respirology noted: “a healthy diet and appropriate lifestyle modifications … are equally important as CPAP treatment in the holistic management of OSA.”²

The authors of a 2010 study published in the journal Chest agree. “Weight loss has been accompanied by improvement in characteristics related not only to obesity but to OSA as well, suggesting that weight loss might be a cornerstone of the treatment of both conditions.”³

Weight loss can be difficult to achieve if you’re also suffering from other symptoms of sleep apnea (like constant sleepiness and lack of energy). Another option for those who have had difficulty losing weight with lifestyle changes alone may be bariatric surgery, which has had impressive results in reducing the severity of sleep apnea.³

A holistic approach to treating sleep apnea

Although the connection between sleep apnea and obesity is well established, and treating one may help treat the other, there are many other factors to consider. “OSA is a complex condition, and treatment cannot be limited to any single symptom or feature of the disease,” the 2010 Chest study notes. “Rather, a multidisciplinary and integrated strategy is required to achieve effective and long-lasting therapeutic success.”³

What’s that mean? Basically, weight loss can help alleviate conditions associated with both sleep apnea and obesity. But for those diagnosed with sleep apnea — or who think they may have the condition — weight loss may be just one factor in a therapy program that includes other options such as CPAP therapy.

It may not always be easy to find the right treatment plan but finding one is vitally important. Clinical evidence shows that, taken together, sleep apnea and obesity can leave people at a greater risk for fatal health events. A 1991 study published in the Journal of Internal Medicine found that “morbidly obese men with a history of OSAS [obstructive sleep apnea syndrome] have a high risk of sudden cardiovascular death, despite the absence of other conventional risk factors.”⁴

If you think you may be at risk for sleep apnea, take the sleep apnea symptom quiz or talk to your doctor.

This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor.

References

1. Source: Shahn N, Roux F. “The relationship of obesity and obstructive sleep apnea.” Clinics in chest medicine. 2009 Sep;30(3):455-65.
2. Source: Lam JC, Mak JC, Ip MS. “Obesity, obstructive sleep apnoea and metabolic syndrome.” Respirology. 2012 Feb;17(2):223-36.
3. Source: Romero-Corral A, et al. “Interactions between obesity and obstructive sleep apnea: implications for treatment.”Chest. 2010 Mar; 137(3):711-9.
4. Source: Rossner S, et al. “The sleep apnoea syndrome in obesity: risk of sudden death.” Journal of internal medicine. 1999 Aug; 230(2):135-41.