Bariatric Surgeon Dr. Hossein Bagshahi: Bagshahi Bariatric and General Surgery

The relationship between sleep apnea and obesity

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Obstructive sleep apnea (OSA), a sleep disorder that affects an estimated 25 million adults nationwide, occurs when your throat muscles relax during sleep and your airway narrows, making it more difficult to breathe and momentarily startling your body awake.

This cycle can occur many times throughout the night, and although you usually won’t remember these disruptions in the morning, your body will.

What causes OSA?

Medical professionals have identified a few factors that can predispose a person to OSA, including the shape and size of their head, neck, tongue and tonsils. You are also more likely to suffer from sleep apnea as you age.

However, the development of OSA is most closely tied to obesity and, more specifically, a large neck circumference, since excess fat around the neck puts more pressure on the throat. The additional pressure, combined with the natural relaxation of your muscles during sleep, contributes to further restriction of the airway.

Obesity as a side effect

Obesity is a major risk factor for obstructive sleep apnea, but the relationship between the two conditions doesn’t stop there. They tend to go hand in hand, with each acting as a possible cause or side effect of the other. In other words, obesity can lead to OSA and OSA can lead to obesity.

Why is this? Even though you may not remember being startled awake, the disruptions OSA causes throughout the night make it harder for you to fall into a sound sleep. You may wake up feeling just as tired as you did when you went to bed. A jam-packed schedule makes it hard enough to carve out time for exercise, but it’s even more of a challenge when you feel exhausted every day. What’s more, the effects of sleep deprivation night after night build up over time, increasing cortisol levels and setting the stage for weight gain.

Lastly, a 2004 study carried out by the Stanford University School of Medicine suggests that when you don’t get enough sleep, your body has difficulty maintaining a healthy level of hormones important for regulating your appetite, consequently prompting you to eat more.

Options for treatment

The good news is that because these two conditions are so closely related, treating one generally will also have a positive effect on the other. Use of a continuous positive airway pressure (CPAP) device, for example, has proven to be effective for treating sleep apnea and providing a more restful night’s sleep, thus helping prevent hormonal imbalances and increasing energy levels during your waking hours.

Sustained weight loss — whether through diet and other lifestyle changes or through bariatric surgery — has also been shown to improve OSA symptoms. One study indicates that even losing 10 percent of your weight could lower the number of apneas or hypopneas experienced per hour of sleep (also known as AHI) by approximately 26 percent. Surgical weight loss, according to the American Society for Metabolic and Bariatric Surgery, produces even more dramatic results, reducing AHI by 71 percent.

If you are concerned that your weight may be affecting the quality of your sleep, make an appointment to talk to Dr. B today to explore which treatment option may be the best for you.

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