Being overweight or obese is one of the main risk factors for obstructive sleep apnea, but the connection doesn't stop there. Most sleep apnea patients carry at least a few extra pounds, and doctors stress diet and exercise as part of their treatment, but getting back to a healthy weight can be difficult.
Gaining weight can bring on sleep apnea …
After the birth of his daughter and a hectic year of studying for the California bar exam, Mark Yanis let exercise and nutrition fall by the wayside. Soon he had gained about 20 pounds, always felt run-down, and was having trouble sleeping through the night.
"My body was jolting me awake and I was starving for air," says Yanis, 49, of Huntington Beach, Calif. He snored so loudly that his wife often slept in another room. He had trouble moving around and catching his breath, and was tired all the time.
Eventually Yanis was diagnosed with obstructive sleep apnea. Doctors told him that his high tongue and narrow airways were part of the problem and, at 5'10" and 220 pounds, that the extra weight he was carrying brought it to the surface.
"The physical presence of extra tissue and fat in the neck compresses the area related to sleep apnea," explains Charles Kimmelman, MD, director of the New York City Ear, Nose and Throat Center (which specializes in sleep apnea treatments). "The airway becomes more narrow, while the organs and tissues swellmaking for very little room for the traveling oxygen."
… Just as apnea contributes to weight gain
On top of this, people who don't sleep well are at a higher risk of becoming obese. In 2004 a Stanford University and University of Wisconsin study found that sleep-deprived people had higher levels of a hormone that triggers appetite and lower levels of a hormone that suppresses it.
Overweight sleep apnea patients usually know that the extra pounds they carry are contributing to their problem, but with barely enough energy to stay awake even during simple conversation, exercise can seem like a foreign concept.
Solving one problem often improves the other
Matt Hanover, 44, has struggled with both weight and sleep problems since adolescence. "I spent every day feeling like I'd been hit by a truck," says the digital media producer in Santa Monica, Calif. "I was too tired to walk up a flight of stairs or around the block."
Once he was diagnosed with sleep apnea and began using an oral breathing device to keep his airway open at night, though, he found that daily exercise wasn't so daunting anymore. "Now that I have more energy, it's easier to be more active," he says. "I've lost 20 pounds since I started my treatment, and hope to lose even more."
Yanis also tried traditional sleep apnea treatments, including an oral breathing device and a continuous positive airway pressure (CPAP) machine, but couldn't get used to wearing either one all night long. But when self-esteem and health worries motivated him to start lifting weights and bikingand he lost more than 50 pounds over the next three yearshis symptoms gradually decreased.
His wife moved back into the bedroom, and with his doctor's guidance, Yanis was able to wean himself off his CPAP machine altogether. Now he only occasionally experiences mild apneas and tries to prevent them with lifestyle adjustments, like sleeping on his side to keep his airway open.
Yanis knows that weight loss changed his sleeping patterns and his life. "Now I feel great, especially after a workout," he says. "Whenever I pick up my 30-pound daughter, it amazes me that I was walking around with much more extra weight than that all the time."
Weight loss can help anyone who is overweight, regardless of age or severity of symptoms, reduce the frequency of their sleep breathing disorders, says Dr. Kimmelman.
If you're overweight and have sleep apnea, it's important to approach the two issues together. Losing weight isn't easyespecially if you've never dieted or exercised. But with the help of your doctor, small changes can yield big results.