Lose Weight by Treating OSA

Wendy has been trying to lose the extra weight she gained following the birth of her second child for about five years now.  Despite various diet and exercise programs, she is still about seventy pounds above her ideal body weight.  She finds her biggest challenges are having the energy to exercise consistently and a tendency to snack frequently—often on unhealthy foods—throughout her hectic day working as the office manager of a busy dentist’s office.  During a recent visit to her family doctor, it was suggested she might have sleep apnea due to her obesity and could benefit from using a CPAP (Continuous Positive Airway Pressure) machine at night to improve her sleep.

Obesity and sleep apnea

Obesity is becoming a significant problem in the United States.  According to the National Institute of Health, over two-thirds of adults in the U.S. are overweight or obese.  Obesity rates are high among men (72.3%) and women (64.1%), and the costs are steep:  obese people pay an average of $1,429 (42%) more in annual health care costs than those who are normal-weight.  Defined as having a body mass index (BMI) above 30, obesity can lead to a variety of health problems, including type 2 diabetes, heart disease, high blood pressure, arthritis and stroke. 

Sleep apnea is also strongly linked to obesity—in fact, among those considered severely obese (BMI greater than 40), estimates for the prevalence of sleep apnea range from 55% to 90%.  The severity of sleep apnea is also affected:  the more overweight a person is, the more frequently pauses in their breathing occur during the night, and their oxygen levels are likely to drop further than those with sleep apnea who are not overweight. 

Untreated sleep apnea can promote weight gain

For those who have developed sleep apnea as a result of gaining weight, leaving the sleep apnea untreated can cause significant problems to their efforts in losing weight.  One study found that subjects who were sleep-deprived had markedly higher appetite and hunger ratings than participants with normal sleep.  The sleep-deprived participants were also noted to particularly crave sweets, starch, and salty snacks.  Taken together, these results suggest that untreated sleep apnea can leave a person with a larger-than-healthy appetite for foods that are not beneficial to their weight loss efforts.

Sleep apnea also affects the body’s ability to regulate how it uses energy by producing imbalances in the hormone leptin, which controls energy intake and expenditure.  Between subjects with similar elevated weights, studies have found those with untreated sleep apnea to have higher leptin levels than those without.  Increased leptin levels may lead to increased calorie intake for some individuals. 

CPAP and other OSA Treatments Can Improve Weight Loss

Fortunately, animal studies investigating sleep and weight change have found that changes in sleep due to weight gain can be reversed by weight loss—suggesting this could be true for humans as well. 

The primary treatment for sleep apnea is CPAP—Continuous Positive Airway Pressure.  It involves wearing a mask—usually fitting over the nose—attached to a machine by a hose.  Similar to a fan, the machine blows air at a set pressure that works to keep the throat and airway held open when it relaxes after the brain goes to sleep.  Since their airway remains open, a person wearing CPAP is able to stay asleep continuously, rather than have their sleep interrupted by the brain as it wakes the body up to reopen the airway. 

A 2008 study published in the Journal of Clinical Sleep Medicine found that while CPAP is not sufficient on its own to produce weight loss, it does provide improved daytime alertness and energy levels—which can greatly help with efforts to increase exercise and physical activity.  Additionally, improving leptin imbalances can help with maintaining a healthy diet and meal plan—instead of snacking on sweet, salty and starchy foods throughout the day. 

Other treatments such as Dental Devices, Surgery, Behavioral Therapy, Medications, if successful at reducing the symptoms of sleep apnea, increasing engery and normalizing metabolic hormones, can also be seen as a means to losing weight. Each treatment has its individual benefits and success rates.

Wendy was diagnosed with sleep apnea following a sleep study and prescribed a CPAP machine, which she uses each night at home.  “It’s nice to wake up feeling like I’m rested enough to meet the day head on,” she says.  “Of course, it’s still up to me to exercise and eat healthy—but I find that easier to do now that my sleep apnea is in the past.”