Obesity and Obstructive Sleep Apnea

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A number of sleep disorders are related to obesity. Prominent among these is obstructive sleep apnea (OSA).

What Is Obstructive Sleep Apnea?

Obstructive sleep apnea falls under the broad category of sleep disorders, and is characterized by disordered breathing during sleep. Specifically, the upper airway becomes obstructed during sleep, which partially or completely blocks air flow. This causes the person with OSA to experience the effort of straining to breathe, which then wakes him or her up.

This can happen hundreds of times during the night, resulting in poor quality of sleep and daytime sleepiness, or somnolence.

Signs of OSA can include: excessive snoring, gasping for air during the night (usually witnessed by a sleeping partner), feeling excessively sleepy during the day (also known as hypersomnolence), morning headaches, sexual dysfunction, and high blood pressure. The diagnosis of OSA is often made in a sleep laboratory using polysomnography.

Obstructive Sleep Apnea and Obesity

OSA is closely tied to obesity. Some studies estimate that it affects as many as 20% of middle-aged adults who have a body mass index (BMI) [link] between 25.0 – 28.0 kg/m2. For those who have a BMI of 30 (reaching the definition of obesity), more than 40% will have OSA. And for those with a BMI of 40 or more (the definition of morbid obesity), OSA is extremely common. Thus, the likelihood of having OSA—and the severity of the disease—increases with increasing levels of obesity, as reflected in the higher BMIs.

Among risk factors for OSA, obesity and large neck size often top the list. The sheer weight of increased tissue around the neck can press down on the windpipe and upper airway when lying down, thus closing off the airway and causing OSA as described above. Obesity as a risk factor for OSA appears to be especially important in men, in whom OSA occurs more commonly than it does in women.

Furthermore, obesity as an underlying cause for OSA appears to play much more of a role in adults than it does in children.

Related Consequences of Obstructive Sleep Apnea

OSA is linked to cardiovascular disease, including high blood pressure and congestive heart failure, because of the stress to the body caused by this breathing disorder.

OSA is also associated with diabetes and insulin resistance, which are in turn connected to obesity. OSA has also been seen with cardiac arrhythmias like atrial fibrillation, and may exacerbate such arrhythmias, even making them more difficult to treat. Additionally, studies have suggested associations of OSA with stroke, heart attacks during the night, and sudden cardiac death.

Weight Loss Can Help

The good news is that OSA is considered to be a treatable condition, and for those who are obese, losing weight can help a great deal in lessening or even eliminating the occurrence of the disease. Weight loss can improve air flow and oxygenation, decrease snoring, and improve the quality of sleep.


Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 2008;118.

Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Ch. 79. Elsevier: Saunders, 2012.

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