What if I told you that people tend to gain weight on CPAP. Although this may be true the reason why is rather interesting. Obesity is the most common risk factor for obstructive sleep apnea. Usually as we gain weight, apnea gets worse. Fortunately the opposite is also true. If we loose weight, obstructive apneas tend to improve. So then why would we gain weight if we treat our sleep apnea?
Everything revolves around food. Every time we celebrate, every time we have a meeting, it revolves around food. Sometimes we eat without being hungry. Other times we may be thirsty or sleepy, yet we interpret that as being hungry. Food gives us pleasure but it also bring problems. In the following we will talk about how weight affects or improves sleep apnea, before and after treatment.
How are weight and sleep apnea related?
We now know that with obesity there is a higher chance of insulin resistance and type-2 diabetes. There is a higher chance of high blood pressure, sexual dysfunction, headaches, and depression. The interesting part is that apnea alone is also an independent risk factor for high blood pressure, sexual dysfunction, headaches, and depression. Obesity and sleep apnea obviously tend to co-exist. But what percentage of sleep apnea patients are obese? Although the exact number varies, the majority of patients, however, are at least overweight. Obviously not every obese patient by body mass index (BMI) has obstructive sleep apnea; but the higher the BMI the more likely OSA. The link between sleep disorders and weight gain is clearly there. And it can be a vicious cycle. Insufficient sleep can lead to weight gain, which produces more sleep deprivation and more packing on of the pounds. Exactly how lack of sleep affects our ability to control weight has a lot to do with our hormones.
Two key hormones involved are ghrelin and leptin. Ghrelin is a hormone that tells us to eat. When we are sleep-deprived our bodies tends to overproduce ghrelin. Leptin tells us that we are satisfied and full. When we’re sleep-deprived, we make less leptin.
Is it harder for someone with sleep apnea to lose weight?
Depriving yourself of sleep was thought to decreases in metabolism, which, in dramatic cases, slows to the point where you couldn’t lose weight. Science debates this idea. Insulin resistance, glucose intolerance, and elevation in blood pressure however are all well established. Being treated for OSA with CPAP is not weight loss strategy. The hope is that if you can control your sleep apnea you will get more restful sleep so you won’t have these fluctuations in hormone levels. By resting better you will be more motivated to proceed with an exercise program, and you will have more energy to proceed with a weight loss program.
After I start CPAP will I lose weight?
A study which appeared in the Journal of Clinical Sleep Medicine found that this was not the case. Unfortunately it seems that using CPAP was found to cause statistically significant (albeit mild) weight gain when compared to sham CPAP. This prospective randomized study probably may come as a shock to most patients. OSA patients using CPAP may gain a modest amount of weight with the greatest weight gain found in those most compliant with CPAP. The reasoning behind this is really not known. Some postulate that if you treat your OSA, patient’s tend to feel better and therefore revert to a bad diet and gain weight.
CPAP works, but they’re not cures for obstructive sleep apnea. The only sure way to rid yourself of the condition for good is to either lose weight or relieve any significant obstruction. Surgery can have side effects which can outweight the inconvenience of wearing CPAP, which is why it’s usually viewed as a last resort