Sleep apnea and weight loss, if you aren't getting adequate sleep every night, it can affect your cortisol levels in your body and make it harder to lose weight.
Losing weight is a daunting task for most people, and after trying diets, different exercise routines and changes in lifestyle sometimes you might find that the weight just isn't coming off like you would want it to. So then we have to think about other things that might be slowing your weight loss. One very common cause of this is something called sleep apnea.
Sleep apnea it's typically caused by having an increased neck circumference which makes it harder for you to breathe at night when you are sleeping. In addition to this you have moments of “apnea” or times when you are not breathing. This ends up being a problem because when you breathe out normally, you're letting carbon dioxide or CO2 out of your body. If you have apneic episodes you keep too much CO2 in your body and this can affect your cortisol levels. Now this is important with weight loss because cortisol helps your body know how to store or break down different nutrients that you take in. So if your cortisol levels are high this can cause your body to retain excess calories and slow weight loss.
If you're worried you might have sleep apnea, one of the most common things that you will hear is that you snore loudly when you sleep (although this isn’t a requirement). All this to say if you're worried there's a quick questionnaire, called the STOP-BANG questionnaire, that you can take to assess your risk.
Snoring: do you snore loudly (loud enough to be heard through closed doors or your bed partner elbows you for snoring at night?
Tired: do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?
Observed: Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep ?
Pressure: do you have or are being treated for High Blood Pressure ?
Body mass index: more than 35?
Age: older than 50?
Neck size: larger than 16 inches (female), or 17 inches (male)?
If you answered “YES” to 3 or more of these questions, you are at or having sleep apnea and should be evaluated by your doctor.
The first step is to do an overnight oximetry test, which is when a pulse oximeter is sent home with you from the doctor’s office. This is a clip that you place at the end of one of your fingers that measures the level of oxygen in the blood circulating in your body. Normally, we want this level to be above 90%. When it drops below this level, that can tell the doctors that you are having moments where you aren’t breathing well during the night. If your test does show blood oxygen levels below 90%, you have two options. You can get a sleep study where you sleep in a bed in the hospital and are observed sleeping to see if you stop breathing and your oxygen saturation also goes down. This helps to confirm a diagnosis of sleep apnea. The other option is to start treatment without a sleep study by using a CPAP machine. CPAP stands for continuous positive airway pressure, which is just a fancy way of saying it will help you to keep your airways open so you breathe okay during the night. Most people didn't want to try CPAP machines because they used to be bulky and uncomfortable, but as their use has become more common, changes to their design have been made that help them be more comfortable and less of a hassle to use while you're sleeping. Depending on how you sleep, there are many different styles available.
Another important way to promote weight loss goes back to what was talked about earlier with cortisol. Cortisol in your body is regulated by your sleep schedule. So if you aren't getting consistent and adequate sleep every night, it can affect your cortisol levels in your body and make it harder to lose weight. So this is where sleep hygiene comes in. There are many easy ways to improve your sleep, whether it be waking up at the same time, staying away from electronics before bed, or playing relaxing music as you wind down for the day. There are many resources like this one that can give you more ideas!
Eva Shelton, M.D.
Harvard Medical School, Brigham and Women's Hospital