Weight Loss Eases Sleep Apnea Symptoms

It’s well known that overweight adults are at greater risk for a myriad of health problems and that losing weight can reduce that risk. Just a 10 percent reduction in weight can improve heart function, lower blood pressure and levels of blood cholesterol and triglycerides, and decrease the risk of diabetes and cardiovascular disease. And new research shows that obese people with sleep apnea who lose 10 percent of their weight can significantly improve their symptoms and potentially rid themselves of the disorder.

Gary Foster, director of the Center for Obesity Research and Education at Temple University in Philadelphia, and researchers at four other medical centers and universities analyzed data on 264 obese patients with type 2 diabetes and sleep apnea in varying forms. The participants were divided into two groups. One group participated in a diabetes management program while the other group followed an intense lifestyle treatment program that included a combination of a group behavior modification, a portion-controlled diet with liquid meal replacements, and 175 minutes of weekly physical activity.

After a year, the treatment group had lost an average of 24 pounds, or about 10 percent of their starting weight, compared with a one-pound average weight loss in the other group. The treatment group also saw a significant reduction in the number of sleep apnea episodes they experienced; many moved to a less severe category, from moderate to mild for example, and about 14 percent had complete remission of the disorder. Men, those with severe apnea and those who lost the most weight saw the greatest benefit. In sharp contrast, those in the second group experienced a worsening of their sleep apnea symptoms. “This is good news because it shows that a little bit of weight loss can go a long way when it comes to improving sleep apnea,” said Foster. “And a reduction in sleep apnea has a number of benefits for overall health and well-being.”

Sleep apnea affects more than 18 million Americans and has the potential for serious, life-threatening complications. People with sleep apnea literally stop breathing for brief periods during their sleep, usually for ten to twenty seconds but often for a minute or longer and as frequently as 30 times or more per hour. People who are overweight or obese are much more likely to have obstructive sleep apnea (OSA), the most common form of the disorder, because excess weight can cause the airway to collapse during sleep. “The soft palate in the back of mouth falls down and blocks the airway,” explains Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill Hospital in New York City. “When you get to people with serious levels of obesity, it’s virtually impossible to find those without sleep apnea.”

Sleep apnea often goes undiagnosed. Doctors usually can’t detect it during routine office visits and there are no blood tests for the condition. The majority of people who have sleep apnea aren’t aware they have it because it only occurs during sleep. Sleep apnea often results in feelings of fatigue and excessive daytime sleepiness, since the ability to reach deep, restorative sleep stages is impaired. Untreated, sleep apnea can increase the risk for high blood pressure, heart attack, stroke, obesity, diabetes and premature death. “It really has tremendous detrimental effects on the cardiovascular system,” Roslin stressed.

Weight loss is often recommended for obese patients with sleep apnea, but evidence for this recommendation has been limited, with most studies being small, nonrandomized, and focusing on surgically induced weight loss. “This is one of the first and certainly the largest study ever conducted,” Foster said. “It’s been clear that obesity increases the risk of sleep apnea but less clear that if obese people or people with type 2 diabetes lost weight, it would result in significant improvements in their sleep apnea—and it did.”

Foster recommends that obese people who want to lose weight keep track of what they eat, using portion-controlled meals such as Lean Cuisine and Healthy Choice, and walk 30 minutes each day.

The study findings were published in the September 28 issue of the Archives of Internal Medicine.