Obesity and Sleep Apnea

The correlation between obesity and sleep apnea is complex; both significantly impact your quality of life and physical life. Research has shown that there is a direct tie between obesity and the development and severity of obstructive sleep apnea.

Globally, the obesity rate has risen drastically over the last few decades.

Obstructive sleep apnea (OSA), often associated with obesity, is a breathing disorder that affects approximately 39 million people as they sleep.

It is the most common type because the upper airway becomes narrower, restricted, or blocked. Obesity also substantially increases the risk of developing other health issues, such as diabetes, heart disease, sleep apnea, and other medical conditions.

This article will discuss the connection between obesity and sleep apnea and help you understand how excess weight increases the risk of developing sleep apnea. We will also explore how obesity contributes to the progression of obstructive sleep apnea and discuss treatment options.

What Is Obesity?

In general, obesity is categorized as an excessive accumulation of body fat, which may be the result of a combination of various issues, including behavioral factors, environmental and genetic factors. Other contributing problems include poor dietary habits, a sedentary lifestyle, genetic predispositions, overall health, and hormone levels. There are varying degrees of obesity, and one of the most commonly used ways to determine obesity is to take your weight and height to get your body mass index or your BMI.

The following is how people’s BMI is categorized:

Underweight for BMI is <18.5
Average weight BMI is 18.5 to 24.9
Overweight BMI is 25 to 29.9
Obese BMI is 30 to 34.9
Morbidly obese BMI is 35 and higher

There is some margin for error, especially for athletes or older people who have lost muscle mass. In general, excessive body fat can increase one’s risk of developing health issues, including obstructive sleep apnea.

How Does Obesity Increase Your Risk of Sleep Apnea?

Several factors contribute to the link between obesity and obstructive sleep apnea:

Mechanical Factors — Excess weight, particularly fat deposits around the neck and throat called pharyngeal fat, can narrow the upper airway, making it more prone to collapse during sleep. This narrowing increases the likelihood of airway obstruction and apnea episodes. However, skinny people can also experience sleep apnea due to factors like genetic predisposition or anatomical abnormalities. This also leads to snoring, one of the most common sleep apnea symptoms, caused by the air trying to squeeze through the airway.
Inflammatory Pathways — Obesity is associated with chronic low-grade inflammation, which can contribute to the inflammation and swelling of the upper airway tissues. Inflammation further exacerbates airway narrowing and increases the risk of obstructive sleep apnea.
Hormonal Imbalance — Adipose tissue, or fat cells, secrete various hormones and inflammatory mediators that can disrupt the body’s regulatory mechanisms, including those involved in sleep-wake cycles and respiratory control.
Central Obesity — Fat accumulation around the abdomen, known as central obesity, is strongly associated with OSA. Central obesity contributes to changes in intra-abdominal pressure, which can affect respiratory mechanics and exacerbate airway collapse during sleep.

Other Causes of Obstructive Sleep Apnea

Various other factors can cause a person to develop obstructive sleep apnea, also called OSA, including the following:

Family history — Sometimes, our genetic component to obstructive sleep apnea can run in the family.
Anatomical factors — Certain anatomical factors, like enlarged tonsils or having a narrow throat, can make a person predisposed to developing obstructive sleep apnea
Age — Obstructive sleep apnea is more common in older adults due to a gradual and natural loss of muscle in the throat as we age
Gender — Men are more likely to experience obstructive sleep apnea than women, although it increases in women after menopause.
Alcohol and sedative use — People who consume sedatives or alcohol before going to bed can cause the muscles and throat to relax too much, which will increase the chances of airway obstruction.

Symptoms of Obstructive Sleep Apnea

The most common symptoms of sleep apnea include the following:

- Episodes of pausing and breathing while asleep — Often, a spouse or partner will recognize that there are pauses and breathing, sometimes accompanied by drooling, followed by abrupt awakenings as the body struggles to resume breathing
- Loud snoring — While not everyone who snores has sleep apnea, it is one of the most common and noticeable symptoms, especially if it is followed by gasping or choking sounds
- Daytime, tiredness, and sleepiness — If you often feel exhausted during the day, even after a whole night’s sleep, it could be a sign that you have sleep apnea
- Difficulty concentrating — Poor sleep quality can lead to problems with memory, concentration, and being able to pay attention during waking hours
- Mood changes and irritability — Sleep apnea can significantly impact your mood and lead to depression, mood swings, and irritability
- Morning headaches — Due to lower levels of oxygen during the night from sleep apnea, you may wake up with headaches
- Night sweats — Excessive sweating during sleep can be a sign of obstructive sleep apnea, especially if it is in conjunction with other symptoms.
- Insomnia — Insomnia may rescue the muscle tone in the upper-airway reduce oxygen saturation, and with consecutive nights of poor sleep, people can be predisposed to more OSA events.

Diagnosis and Treatment of Sleep Apnea

Obesity complicates the diagnosis and management of obstructive sleep apnea in several ways:

Underestimation of Symptoms — Obesity-related symptoms, such as daytime sleepiness and fatigue, may be erroneously attributed to poor lifestyle habits rather than underlying sleep disorders.
Reduced Treatment Efficacy — Continuous positive airway pressure (CPAP), the gold standard treatment for OSA, may be less effective in individuals with obesity due to difficulties in achieving and maintaining mask fit and airway patency.
Need for Multidisciplinary Care — Managing OSA in obese individuals often requires a multidisciplinary approach involving pulmonologists, sleep specialists, dietitians, and bariatric surgeons.

When it comes to strategies for the prevention and treatment of sleep apnea when associated with obesity, your doctor may recommend the following:

Weight loss interventions, which may include dietary changes, lifestyle modifications, increased physical activity, and behavioral therapy, are all critical components to help with weight loss and reduce the severity of obstructive sleep apnea
CPAP machine uses continuous positive airway pressure (CPAP) to help keep your airways open while you sleep
BiPap machine provides air pressure during both inhalation and exhalation while breathing while asleep

If you are concerned about sleep apnea, talk with your doctor about making an appointment with a sleep specialist and performing an at-home sleep test.

DreamZZ Sleep Center Is Here to Help You With All of Your Sleep Apnea Treatment Needs

Whether you struggle with obesity, tiredness or sleepiness, insomnia, snoring, dry mouth, difficulty staying asleep, or other signs of sleep apnea, we can help you with a sleep study to determine the best treatment plan.

At DreamZZ Sleep Center, our sleep specialists ensure you get the best night’s sleep possible and improve your quality of life and overall health.