An unhealthy body weight can increase the risk of developing sleep apnea, but losing weight can also bring relief to symptoms and, in some cases, cure the condition entirely. Continuous Positive Airway Pressure (CPAP) therapy is a well-known treatment for Obstructive Sleep Apnea (OSA), but it can often cause complications due to its uncomfortable and invasive design. Many patients are seeking alternatives to the restrictive CPAP machine, such as lifestyle changes like weight loss and dieting, that may lead to the ability to sleep freely without the mask.
The Connection Between Weight and Sleep Apnea
The relationship between weight gain and the development of apnea is well understood by medical professionals. When we carry excessive weight, the fat tissue has to be stored in the body. For patients struggling with sleep apnea symptoms, these fat deposits can be problematic in the upper respiratory tract, building up in the airways to cause the pathway to narrow and triggering apnea episodes when the tissues start to relax.
Once apnea has become a re-occurring health issue, the impact on sleep quality can have multiple consequences for the body, including the disruption to brain chemistry and balance of hormones. Grehlin, the hormone responsible for feelings of hunger, is shown to increase in sleep apnea patients, driving them to eat more frequently. The imbalance of the hunger hormones is often seen in both those experiencing sleep disorders and obesity cases, making tackling weight loss an important part of a treatment plan for patients hoping to reduce apnea symptoms and bring body chemistry to normal levels.
Weight Loss as a Treatment for Sleep Apnea
Weight loss programs that incorporate physical activity are the most manageable for reducing body size and addressing high-calorie intake caused by hormone imbalances. However, these can be difficult to maintain when feeling the impacts of daytime fatigue, which is why ongoing support is important. Maintaining a healthy weight is always better for any person than struggling with obesity and will greatly reduce the risk of developing other health conditions. Patients who work towards a healthier body size and lifestyle often report improvements in their joints, blood pressure, and general well-being.
Currently, it is recommended that patients see relief of symptoms and apnea episodes by reducing their body weight by only 10-15%. In the realm of sleep apnea, particularly OSA (Obstructive Sleep Apnea), the role of the neck and airway is crucial, especially during the night when relaxed muscles can lead to a narrowed airway. Reducing neck circumference through weight loss can significantly improve airway patency, thus alleviating symptoms.
Read also: Healthy food access with Highmark Wholecare explained.
How Much Weight Loss Is Needed to Get Off CPAP?
Many patients inquire about how much weight to lose to get off CPAP, highlighting a common goal for those looking to manage their condition more naturally. It is entirely possible to lose 10% of a person’s body weight in a safe, healthy way - and in just under 6 months! For example, a person who is 5 feet 11 inches would need to weigh 215 pounds or more to be diagnosed with obesity. In this case, a weight loss of around 21-33 pounds (10-15%) may result in the improvement of apnea symptoms, particularly those related to OSA (Obstructive Sleep Apnea). As the average person can safely lose up to 1-2 pounds per week, it would be possible to reach 20 pounds of weight loss within only 5 months and hit the recommended apnea threshold by 6 months, although progress can differ between patients. It’s important to note that reducing neck circumference through weight loss can also play a crucial role in alleviating sleep apnea symptoms, as a larger neck can narrow the airway and exacerbate breathing issues at night.
CPAP Therapy and Its Impact on Weight Loss
The relationship between CPAP therapy and weight fluctuations has yet to be fully understood, although it has been documented in some patients. Some patients may experience weight gain as a result of disrupted sleep patterns or hormonal imbalances linked to sleep apnea. Studies suggest a small number of cases will experience weight gain as a result of a CPAP, potentially due to the reduction of leptin levels caused by the treatment.
Treating sleep apnea directly can improve energy levels, mental health, and quality of sleep, all contributing to more positive outcomes in weight loss approaches. Managing sleep apnea, or OSA (Obstructive Sleep Apnea), is crucial not only to prevent the risk of weight gain but also to address overall health issues including those related to ENT (Ear, Nose, and Throat). Even if symptoms have been relieved as a result of the CPAP therapy or weight loss, it is recommended to speak with a professional who may re-test for apnea or evaluate the case to confirm the patient’s medical needs and requirements.
Alternatives to CPAP Therapy
Although CPAP treatment has always been a common treatment of obstructive sleep apnea, there are other options available to patients hoping to sleep freely without a mask. Our Sleep Cycle Team is dedicated to the movement of patients looking for new approaches to managing their sleep apnea, working with the latest advancements in treatments to offer long-term methods that can be incorporated into normal living.
Oral devices for apnea treatment, using a holistic mouth guard over invasive CPAP devices, are available. This comfortable, wireless, and mask-free alternative relieves the symptoms of apnea by repositioning the jaw, reducing the frequency of episodes, and helping patients achieve better quality sleep. In addition to treating sleep apnea, this approach has been found effective in assisting individuals who are trying to lose weight. Improved sleep quality can reduce the risk of weight gain associated with sleep disturbances. Moreover, patients have reported that managing sleep apnea has made their journey of losing weight more manageable, as better sleep often translates to more energy for physical activity. Weight management therapy is actively encouraged as a holistic approach to managing mild medical conditions and improving a patient’s approach to maintaining long-term, better health. This type of therapy educates a person about their lifestyle choices while putting the work into practice, offering clear instructions on achieving recommended weight loss for symptom relief and how to continue to utilize the diet for ongoing management. To avoid weight gain, the program focuses on lifestyle changes rather than quick fixes. Those aiming to lose weight can find this therapy particularly beneficial, as it addresses both the physical and psychological aspects of weight management. For individuals struggling with losing weight, this therapy provides tailored strategies to help them slim down effectively. To ensure comprehensive care, the program is often used alongside a wider treatment plan, which may include recommendations to reduce sleep-related issues that can affect weight.
Read also: Risks of Salad Dieting
CPAP Machines: Benefits and Potential Drawbacks
Continuous positive airway pressure (CPAP) therapy is often the first treatment recommended for people with a diagnosis of sleep apnea. People prescribed a CPAP machine may wonder how their bodies change in response to CPAP use. CPAP therapy is considered safe and has been found to provide many benefits, such as better sleep, reduced snoring, less daytime fatigue, and decreased blood pressure.
A higher body weight is often associated with the most common type of sleep apnea, called obstructive sleep apnea (OSA). For this reason, some researchers have suggested that treating OSA with a CPAP machine may lead to weight loss. However, people with OSA who are overweight should not rely on CPAP therapy alone to help with weight loss.
The Complex Relationship Between CPAP and Weight
Researchers are not entirely sure why treating OSA with a CPAP machine can lead to weight gain. Identifying how CPAP use affects weight is difficult, because so many factors impact body weight, like diet, physical activity, hormones, and other environmental factors. For these reasons, studying the impact of CPAP on weight is challenging and research is limited.
Untreated OSA may cause people to use more energy as they sleep, either due to low oxygen levels or an overactive nervous system. Studies have also found that the basal metabolic rate drops after starting CPAP, which means people burn fewer overall resting calories. Weight gain after CPAP use appears to happen more commonly among people who already had existing issues with the regulation of blood sugar, such as those with diabetes. Weight changes may depend on how much time people spend using CPAP nightly. One analysis found that weight gain only happened in those who used their CPAP machine for less than five hours per night. But, another showed that those who use a CPAP for over four hours per night tend to gain more weight.
Additional Benefits of CPAP Therapy
Treating OSA with CPAP therapy has been found to reduce daytime sleepiness and increase alertness. Although experts are not certain about the exact effect OSA has on anxiety and depression, some suggest the low oxygen levels associated with OSA may lead to brain changes that affect mood. More recently, an analysis of five studies found that, among people who have OSA, using a CPAP machine for at least four hours per night reduces the risk of stroke.
Read also: Microneedling with PRP Explained
There are a few reasons why CPAP use might reduce the risk of stroke in those with OSA. First, OSA can cause fluctuations in blood pressure, low levels of oxygen in the blood, and high levels of carbon dioxide in the blood. Experts suggest that OSA may contribute to build up in the arteries, called atherosclerosis, as well as an irregular heart rhythm called atrial fibrillation, both of which can also contribute to stroke. People with OSA face an increased risk of high blood pressure. Blood pressure improvements may only be seen in those who use a CPAP machine for at least four hours per night. While CPAP may help reduce blood pressure, it is important for people to continue to follow their doctors’ recommendations for blood pressure management. Research shows that treating sleep apnea with CPAP helps improve the heart dysfunction common in heart failure. OSA can cause a person to wake up with a morning headache.
CPAP Therapy and Insulin Resistance
People who have insulin resistance may develop diabetes or experience the disorder more severely. Studies show CPAP could improve these complications in people living with diabetes. In one case study, CPAP therapy combined with weight loss education successfully reversed the green tint a man with diabetes had begun seeing overtop his entire visual field.
Newer Pharmaceutical Approaches to Sleep Apnea
Weight-loss drugs are being prominently advertised on TV and social media, with celebrities touting their effectiveness. A new study finds that tirzepatide, the active ingredient in the weight-loss drug Zepbound and the diabetes drug Mounjaro, appears to reduce the severity of sleep apnea. A pharmaceutical approach to sleep apnea would be a boon to more than 30 million Americans who suffer from sleep apnea.
Twin trials found that tirzepatide reduces the severity of sleep apnea by almost 66% in adults with both apnea and obesity. In both trials tirzepatide achieved its primary and key secondary endpoints, with a mean reduction of up to 63% on the apnea-hypopnea index (AHI), or about 30 fewer obstructive sleep apnea events per hour of sleep. Patients who received tirzepatide also lost 18-20% of their body weight and had improved blood pressure and blood oxygen levels while sleeping. Fewer sleep apnea episodes were most likely a secondary effect of the weight loss. Studies show that as sleep apnea patients lose weight, their condition improves.
Currently, Zepbound and Mounjaro are not FDA-approved for sleep apnea. Eli Lilly has applied for approval, but a decision is unlikely to come before early 2025.
Understanding CPAP Machines
A CPAP (continuous positive airway pressure) machine helps treat sleep apnea. This device delivers continuous air through your mouth and/or nose to help keep your airways open while you sleep. A CPAP machine includes:
- A mask that fits over just your nose or both your nose and mouth.
- Straps to position the mask on your face.
- A tube that connects the mask to the machine’s motor.
- A motor that blows air into the tube.
- An air filter that purifies the air entering your nose or mouth.
Some CPAP machines have other features as well, like heated humidifiers and adjustable pressure settings. A CPAP machine is just one type of PAP (positive airway pressure) device. CPAP is the most common among these machines.
CPAP machines treat obstructive sleep apnea (OSA). In OSA, you briefly stop breathing while you sleep when your airways relax so much that they narrow down or completely close. This can happen hundreds of times in a single night, leading to a lack of oxygen. Untreated sleep apnea increases your risk for conditions like:
- High blood pressure
- Heart disease
- Type 2 diabetes
- Stroke
Untreated OSA can also increase your risk of being in a vehicle accident while driving. Using a CPAP machine when you sleep keeps your airways open, so you don’t stop breathing.