Woman With Sleep Apnea

Can Sleep Apnea Cause Weight Gain? (10 Solutions)

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This article has been written and researched by Ana Luiza – a sleep scientist, psychobiologist, and biotechnologist, (Ph.D.) – to ensure the highest content quality and factual accuracy.

Sleep apnea is a severe sleep disorder that can have serious consequences for your overall health and quality of life.

If you have sleep apnea and have started to gain weight then you might be wondering if there is a link between the two conditions.

So can sleep apnea cause weight gain?

Sleep apnea can cause weight gain by disrupting sleep which in turn reduces your energy levels, increases your desire to eat more calorie-rich foods, creates resistance to the leptin hormone, reduces energy expenditure, and lessens the desire to exercise.

So how can you stop sleep apnea from causing weight gain?

The most effective way to stop sleep apnea causing weight gain is to treat the condition using a PAP machine, oral appliances, or surgery to improve sleep quality, energy levels, and metabolic function. Exercising more and switching to the Mediterranean diet can reduce body weight and reduce symptoms.

The rest of this article explains in more detail how sleep apnea causes weight gain and gives you 10 actionable solutions to stop sleep apnea from causing you to gain weight.

Although this article has been written by a sleep scientist with a Ph.D, you should always consult with your own doctor or another suitably qualified professional for the best advice relative to your condition.

Sleeping on an adjustable bed can improve symptoms: raising the upper portion of an adjustable bed can help to open up your airways, stop snoring, and reduce the symptoms of sleep apnea. Click here to see the best adjustable beds and mattresses to buy now.

5 Ways Sleep Apnea Causes Weight Gain

Obstructive sleep apnea (OSA) is strongly correlated with being overweight and obese.

About 44% of obese men and 13% of obese women between 30 and 39 years old have OSA (2).

Obesity and sleep apnea have a reciprocal relationship – one causes the other – so if you are overweight, you are more likely to have sleep apnea, and if you have sleep apnea then you are more at risk of gaining weight.

Sleep apnea can cause sleep disruptions that contribute to behavioral, hormonal, and metabolic changes that can make you gain weight.

At the same time, being overweight or obese can cause sleep apnea due to airway obstruction.

Sleep apnea can lead to weight gain in the following five ways:

1: Higher Food Intake

One study found that more severe OSA was associated with a higher intake of cholesterol-rich food.

There was also an increased intake of other nutrients like protein, total fat, and saturated fatty acids in women with more severe OSA than women with less severe versions.

2: Preference for High Calorie Foods

One group studied food preference in people with OSA – with fatty foods being more prevalent.

Those people who liked fatty food had a more severe OSA.

3: Hormonal Imbalances

Various hormones and other substances regulate hunger, satiety, and food intake, including orexin, neuropeptide Y (NPY), ghrelin, and leptin.

Studies show that:

  • Leptin (a satiety hormone) increases in people with OSA versus non-OSA. These abnormal levels of leptin can cause leptin resistance and lead to further weight gain.
  • Plasma ghrelin (hunger hormone) levels are also higher in OSA versus non-OSA.
  • Individuals with OSA and daytime sleepiness have higher orexin levels (a food intake stimulator) than OSA without daytime sleepiness.
  • NPY, another hunger signal, is increased in OSA versus controls.

4: Lower Energy Expenditure

OSA is associated with a lower than usual energy expenditure, possibly due to decreased thermogenesis and energy dissipation through heat production.

This could explain why people with OSA tend to gain weight.

5: Reduced Activity Levels

Individuals with OSA tend to exercise less and be less active than those without OSA.

In addition, physical activity decreases in more severe OSA compared to less severe versions of the disease.

These differences can be due to a higher BMI in severe OSA.

10 Ways to Stop Sleep Apnea Causing Weight Gain

The first step towards improving your sleep apnea-related metabolic problems is treating the disease directly.

The therapy goals are to resolve the symptoms, improve sleep quality, reduce daytime sleepiness, normalize blood oxygen levels, and reduce heart diseases risk (6).

As a sleep specialist, I’d like to highlight that this requires long-term and multidisciplinary management since OSA is a chronic disease.

The current recommended treatment options for sleep apnea to prevent weight gain are (6):

1: Improve Breathing With a Positive Airway Pressure Machine

A Positive Airway Pressure (PAP) machine is the most widely used method for treating OSA and it can help to stop your sleep apnea causing weight gain by improving the quality of your sleep so that you have more energy to exercise and your hormone levels are normalized.

The PAP machine gently blows pressurized air through your airway at a pressure high enough to keep the throat open.

The pressure is set according to the user’s needs.

It must fully open the airway when you inhale without disturbing your sleep to prevent upper airway collapse during sleep (7).

Some PAPs provide a continuous stream of air – these are called continuous positive airway pressure (CPAP) machines; others have two pressure levels, one is lower to ease exhaling (BiPAP), or they can vary the pressure during breathing (VPAP) (7).

PAP treatment has shown to (6):

  • Reduce the frequency of breathing interruptions during sleep.
  • Lower daytime sleepiness.
  • Improve blood pressure.
  • Improve the quality of life.

2: Use Oral Appliances if You Can’t Use a PAP Machine

Oral appliances are an alternative for those who can’t adhere to PAP treatment for any reason.

Some people may find these devices easier to use.

Oral appliances for OSA include (6):

  • Mandibular advancement/repositioning splints – a device that moves the jaw and tongue forward, reducing throat constriction and preventing sleep apnea and snoring.
  • Tongue retaining devices – a small piece of plastic that holds your tongue forward. The device prevents the tongue from blocking your throat, alleviating snoring and sleep apnea.

3: Undergo Surgery for Persistent Sleep Apnea

When PAP machines and oral appliances are ineffective, surgical treatment may be recommended.

A surgical correction can be helpful in patients with a severe and surgically correctable obstructing lesion of the upper airway, including abnormalities in the skull, face, tongue, and teeth (6).

4: Exercise More to Lose Weight and Reduce Symptoms

Physical exercise is an effective option to mitigate the harmful consequences of OSA, such as heart diseases, fatigue, and diabetes – plus losing weight can actually reduce the symptoms of OSA because being overweight is a risk factor in itself.

OSA patients who exercise regularly have fewer breathing interruptions during sleep, feel more rested during the day, and have a better sleep at night than those who don’t exercise regularly.

Additional benefits include:

  • Making the upper airway muscles stronger – reducing the chances of them collapsing during sleep.
  • Increasing your body’s resistance – which can help to reduce fatigue.
  • Reducing fluid retention in the neck – fluid accumulation in this region can contribute to airway collapse and worsen OSA.
  • Improving sleep quality by increasing the amount of time spent in deep sleep – causing you to wake up feeling more rested.
  • Reducing inflammation. Our fat tissue is rich in inflammatory substances, which are also high in people with OSA. Physical activity can prevent the negative consequences of this inflammation, reducing cardiovascular risk.

5: Try the Mediterranean Diet to Reduce Body Weight

The American Academy of Sleep Medicine recommends losing weight as one of the lifestyle treatment options for OSA (9).

This weight loss can be achieved through regular physical activity and a healthy diet.

Dietary interventions were shown to aid in weight loss and reduce OSA severity in obese and overweight individuals.

Additionally, a Mediterranean diet – which is rich in olive oil, nuts, vegetables, fruits, cereals, grains, legumes, fresh fruits, and fish; limited in meat or processed meat, and moderate in dairy products – may be more effective than low-fat diets in reducing OSA severity and preventing heart diseases.

6: Sleep On Your Side to Breathe More Easily

Sleeping on your side, also known as positional therapy, is one of the most straightforward treatments for OSA.

In addition, it is an easy and accessible option, which could increase adherence to OSA treatment.

A systematic literature review looked at eight studies, including 323 participants in total.

They compared positional therapy with CPAP and found that CPAP is more effective than positional therapy in reducing breathing interruptions during sleep.

However, positional therapy was better than no treatment at all.

Besides, positional therapy may have higher adherence than CPAP.

Try placing pillows at each side of your body to stop you from rolling over on to your back during the night.

Also, I recommend that when sleeping on your side, you do so on on a memory foam topped mattress because it will be more comfortable on your shoulders.

The best memory foam mattress that I’ve slept on as a side sleeper is the Puffy Lux Hybrid – click here to read my review and analysis.

7: Avoid Alcohol and Tobacco

Studies show that alcohol consumption increases the risk of sleep apnea.

Alcohol reduces the upper airway muscle tone, making it more likely to collapse.

It also favors dietary intake and weight gain in some people.

Thus, reducing alcohol intake is a potential therapeutic option for this condition and to prevent weight gain (11).

Cigarette smoking is associated with increased OSA severity, worse sleep quality, and higher snore frequency in people with sleep apnea.

In addition, smoking can cause sleep fragmentation and daytime sleepiness.

Also, nicotine may interfere with your upper airway muscle reflexes, contributing to sleep apnea.

So, stopping smoking could ameliorate OSA symptoms (12).  

Click here to find out how to get to sleep after consuming nicotine.

8: Try CBT to Combat Negative Cognitive Effects

Sleep apnea often causes cognitive problems such as memory loss, lack of focus, impaired attention and concentration.

In addition, mood disorders like anxiety, irritability, and depression can also occur in people with OSA.

Cognitive-behavioral therapy (CBT), a type of psychological treatment, can help to minimize these issues (13).

One study compared the effects of cognitive-behavioral therapy and CPAP in OSA patients.

Both treatments enhanced cognitive functioning; however, combining the two methods was the most effective therapy for these patients (13).

Therefore, CBT may help to stop sleep apnea from causing weight gain indirectly by reducing your cognitive symptoms and mood disorders which improves your sleep and thus allows you to exercise more and maintain a normal hormonal balance so that your metabolism is kept in an optimal state.

Click here to discover 8 ways to stop OCD thoughts at night.

9: Improve Your Sleep Hygiene

Another measure that can help you not only with OSA, but your sleep in general, is to adopt good sleep hygiene.

Good sleep hygiene includes:

  • Exercise during the day.
  • Avoid long naps during the day.
  • Make sure that your sleep environment is pleasant.
  • Avoid stimulants such as alcohol or caffeine near bedtime.
  • Have a regular sleep-waking schedule.
  • Expose yourself to the daylight.
  • Avoid light exposure during the night.
  • Only go to bed when you’re sleepy.
  • Avoid stressful situations near bedtime.
  • Have a healthy diet and avoid fatty, fried, heavy food near bedtime.

Click here to discover 19 ways to make your bedroom pitch black for better sleep.

10: Elevate the Upper Portion of an Adjustable Bed

Elevating the upper portion of an adjustable bed can help to reduce the symptoms of sleep apnea by opening up your airways so that you don’t experience choking.

This will help you to stop gaining weight indirectly because you will be more rested the next day which will help to curb food cravings, give you more energy to exercise, normalize hormone levels, and improve your metabolic state.

An adjustable bed is better than using pillows to elevate your upper body because it is more stable and is less likely to cause neck pain.

Click here to see the best adjustable beds and mattresses to buy online now.

Guide to Sleep Apnea

Below is a short guide that explains what sleep apnea is, the symptoms, and how it affects sleep:

What is Sleep Apnea?

Sleep apnea is a condition where your upper airway collapses during sleep – resulting in less oxygen reaching your blood, which results in a reduction in the oxygen supply to your body’s tissues (1).

Sleep apnea can kill you – mainly via associated its conditions like obesity and heart disease – rather than the pauses in breathing directly.

There are two types of sleep apnea, central sleep apnea and obstructive sleep apnea (OSA) (1).

OSA is one of the most common sleep disorders in the United States, affecting 4% of middle-aged men and 2% of middle-aged women (2).

In this condition, the muscles of the back of the throat relax, causing multiple interruptions in breathing during sleep.

These muscles can relax entirely or partially, leading to a reduction (hypopnea) or cessation (apnea) in airflow (1).

Central sleep apnea is when you stop breathing during sleep because your brain doesn’t send the signal to the muscles that control breathing.

Central sleep apnea does not involve upper airway obstruction, and it is less common than OSA (3).

What Causes Sleep Apnea?

The main causes and risk factors of sleep apnea include:

  • Anatomical features – including the size and location of your neck, jaw, tongue, and other tissues.
  • Obesity – fat deposits around the neck can cause a narrowing of the airway.
  • Alcohol or sedatives – these substances relax the muscles, facilitating OSA.
  • Family history – if you have close relatives with OSA, it’s more likely that you’ll have it too.
  • Smoking – increases the risk of developing OSA.
  • Sleep position – sleeping on your back facilitates airway collapse.
  • Nasal congestion – people who can’t breathe through the nose are more likely to experience OSA.
  • Hormonal problems – such as hypothyroidism (decrease in thyroid activity) and acromegaly (excess of growth hormone) cause swelling of tissue near the airway.

Central sleep apnea is usually related to other health conditions that affect your brain’s ability to control your breathing, like heart failure and stroke (3).

How Do You Know if You Have Sleep Apnea?

Most people with OSA are unaware of their breathing problems until their bed partner tells them.

In my practice, I’ve noted that not all people who snore have sleep apnea.

However, snoring, choking or gasping during sleep, and unrefreshing sleep are the most typical sleep apnea symptoms.

People with OSA usually experience (5):

  • Excessive daytime sleepiness.
  • Unrefreshing sleep.
  • Tiredness.
  • Lack of energy.
  • Snoring.
  • Gasping or choking during sleep.
  • Morning sore throat or dry mouth.
  • Headaches.
  • Waking up during the night.

What Are the Consequences of Sleep Apnea?

OSA is highly associated with being overweight and obese.

About 44% of obese men and 13% of obese women between 30 and 39 years old have OSA (2).

As a sleep Ph.D, I’ve seen that losing weight is effective for most patients seeking OSA treatment.  

Sleep apnea can result in the following conditions:

  • Weight gain and obesity.
  • Broken sleep.
  • Daytime tiredness.
  • Increased blood pressure.
  • Decreased insulin sensitivity.
  • Increased risk of type 2 diabetes.
  • Increased risk of heart diseases.
  • Increased inflammation.

Conclusion: Treat Sleep Apnea to Stop Weight Gain

Because weight gain is a consequence of sleep apnea, then the most effective way to prevent this weight gain is to treat the condition directly with a PAP machine, oral appliances, or – in severe cases – surgery.

However, because being overweight is also a risk factor for sleep apnea, you should take action to actively reduce your body weight through exercise and improving your diet.

Sleeping on an adjustable bed can also help to reduce the symptoms of sleep apnea by elevating the upper portion of the bed to open up your airways.

Adjustable beds are also great if you have back pain and a range of other conditions like acid reflux, arthritis, and excessive snoring.

Click the button below to see the best adjustable beds and compatible mattresses to buy online now.

Click Here to See the Best Adjustable Beds for Sleep Apnea and Back Pain

Sources and References

[1] Daniel J. Gottlieb, MD, MPH; Naresh M. Punjabi, MD P, IMPORTANCE. Diagnosis and Management of Obstructive Sleep Apnea A Review. Clin Rev JA. 2020;14:1389–400.

[2] Ralls F, Cutchen L. A contemporary review of obstructive sleep apnea. Curr Opin. 2019;25(6):578–93.

[3] Clinic M. Central Sleep Apnea [Internet]. Available from: https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109

[4] Schwab RJ. Snoring – Neurologic Disorders – MSD Manual Professional Edition. 2020. p. 1–6.

[5] Gould J. Sleep Apnea. 2020. p. 1–10.

[6] Uptodate. Management of obstructive sleep apnea in adults [Internet]. Available from: https://www.uptodate.com/contents/management-of-obstructive-sleep-apnea-in-adults

[7] Association ASA. No Title [Internet]. Available from: https://www.sleepapnea.org/treat/sleep-apnea-treatment-options/positive-airway-pressure-therapy/

[8] Andrade FMD de, Pedrosa RP. The role of physical exercise in obstructive sleep apnea. J Bras Pneumol [Internet]. 2016;42(6):457–64. Available from: https://pubmed.ncbi.nlm.nih.gov/28117479

[9] Dobrosielski DA, Papandreou C, Patil SP, Salas-Salvadó J. Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk. Eur Respir Rev [Internet]. 2017 Jun 28;26(144):160110. Available from: https://pubmed.ncbi.nlm.nih.gov/28659501

[10] Srijithesh PR, Aghoram R, Goel A, Dhanya J. Positional therapy for obstructive sleep apnoea. Cochrane Database Syst Rev [Internet]. 2019;(5). Available from: https://doi.org//10.1002/14651858.CD010990.pub2

[11] Simou E, Britton J, Leonardi-Bee J. Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Med [Internet]. 2018/01/03. 2018 Feb;42:38–46. Available from: https://pubmed.ncbi.nlm.nih.gov/29458744

[12] Krishnan V, Dixon-Williams S, Thornton JD. Where there is smoke…there is sleep apnea: exploring the relationship between smoking and sleep apnea. Chest [Internet]. 2014 Dec;146(6):1673–80. Available from: https://pubmed.ncbi.nlm.nih.gov/25451354

[13] Talebi M, Tabatabaye KR, Vahedi E. Application of cognitive-behavioral therapy in obstructive sleep apnea: Comparison of combined treatment, and CPAP therapy on executive functions of the brain. Sleep Hypn. 2018;20(3):148–59.

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