At a Glance
Weight loss can make obstructive sleep apnea less severe and may improve AHI scores, but it rarely makes OSA go away completely. Even after losing weight, many people still need CPAP or another form of treatment. If your weight changes significantly, talk with your doctor before adjusting or stopping sleep apnea therapy.
Excess body weight is one of the strongest risk factors for obstructive sleep apnea (OSA), so doctors often recommend weight loss as part of treatment. Losing weight can help reduce OSA symptoms, occasionally stopping them altogether. However, most people still need sleep apnea treatment after shedding pounds.
Below, learn how sleep apnea and weight loss affect each other and how much weight loss it takes to make a difference for this sleep disorder.
How Does Weight Affect Sleep Apnea?
Research suggests that excess weight may cause up to 60% of OSA cases. Other studies show up to 90% of people with class III obesity (a BMI of 40 or above) have OSA.
When you have obstructive sleep apnea, your tongue or excess tissue in your neck can narrow or block your upper airway repeatedly while you sleep. And when your body weight increases, you have more fat around your upper airway. Then, when your muscles relax during sleep, the weight of that extra tissue can block air from getting through.
Carrying extra body weight can also prevent your lungs from expanding fully, which can contribute to breathing pauses. The more weight you gain, the higher your risk of blockage.
Can Weight Loss Reverse Sleep Apnea?
Weight loss rarely reverses sleep apnea, but it can help improve symptoms and apnea-hypopnea index (AHI) scores. AHI measures how many times your breathing gets shallow, pauses, or causes low oxygen levels each hour you sleep.
One study review found that every 10% decrease in BMI equaled over a 20% decrease in AHI. These results tapered off once participants decreased their BMI by more than 20%. Other studies have found less of a connection between weight loss and improved OSA, but experts still say weight loss can make sleep apnea less severe.
Weight loss may also improve your sleep architecture (time spent in various sleep stages). One study of people with OSA and type 2 diabetes linked better AHI scores to more deep sleep and weight loss to less wakefulness.
Some people may reach sleep apnea remission (AHI lower than five) through weight loss, but it’s rare. In the study above, those who lost weight had a higher rate of OSA improvement than the group that didn’t lose weight. But even in the weight loss group, only 13.6% reached remission.
Does CPAP Help With Weight Loss?
CPAP therapy and weight loss work together to improve sleep apnea, but evidence is mixed on whether this treatment can help you shed pounds. OSA makes it easier to gain weight because of interrupted sleep, daytime sleepiness, and unbalanced appetite hormones.
Because of this two-way link, improving sleep apnea may help you lose weight more easily. However, some studies show treating sleep apnea with CPAP can lead to a small amount of weight gain.
Breathing with OSA takes a lot of work and burns extra calories, so experts think using a CPAP may lessen that load and help you hold on to those calories. The pressure from a CPAP can also tell your brain to hold on to extra water, which also adds weight.
Even if your weight fluctuates while on CPAP, it’s still important to use it every night. If your OSA improves enough that you think you may not need it, tell your doctor. They can schedule another sleep study to double-check your AHI.
Is It Sleep Apnea? Find Out for as Low as $0
Sleep Doctor’s home sleep study helps diagnose obstructive sleep apnea, and it's covered by most major insurance plans.
Who Is Most Likely to See Sleep Apnea Improve?
Individual factors make a difference in how OSA responds to weight loss. One study of people with OSA and type 2 diabetes found that men and people with higher starting AHI scores saw more sleep apnea improvement with weight loss.
Other sleep apnea causes and types may not respond to weight loss as well as treatment. For example, if you have sleep apnea but aren’t overweight, losing weight may not improve your symptoms. And central sleep apnea (CSA) happens because of problems with brain signals that manage breathing, which isn’t affected by weight.
How to Lose Weight When You Have Sleep Apnea
You can lose weight with sleep apnea through lifestyle changes, medication, and surgery. You can discuss the options below with your doctor to find the best treatment path.
Eat a Balanced Diet
You can promote a healthy weight by eating a balanced diet. A healthy diet includes fruits and vegetables, whole grains, and lean protein.
Try to limit foods and drinks with added sugars, saturated fats, and salt. In one study, participants limited their daily calories to 1,200 to 1,800 a day, depending on their starting weight. They used portion control and kept calories from fat under 30%. Dieting can feel overwhelming, and if you need help developing a nutrition plan, you can ask your doctor for a referral to a dietitian or nutritionist.
Exercise Consistently
Exercise can help you lose weight and also comes with a long list of other benefits, like better sleep, improved mental health, and lower blood sugar levels. Try to do 150 minutes per week of moderate-intensity aerobic exercise, like brisk walking, cycling on flat terrain, or dancing.
Also include muscle-strengthening exercises at least two days a week. These could include lifting weights or using resistance bands or your own body weight to strengthen your muscles.
Ask About Medication
Your healthcare provider may recommend glucagon-like peptide-1 receptor agonist (GLP-1) injections for weight loss to treat OSA. The U.S. Food and Drug Administration has approved one GLP-1, tirzepatide (Zepbound), for adults with obesity who have moderate-to-severe OSA. Studies show this medication helps you lose weight and leads to a lower sleep apnea severity. Your doctor can help you decide if you’re a good candidate for a GLP-1.
Explore Bariatric Surgery
Bariatric surgeries involve various techniques to help you eat less and lose weight by placing bands around your stomach or redirecting food around the stomach. Your doctor may recommend bariatric surgery if you’ve tried other weight loss methods like those above without success and your BMI is over 40, or over 30 with other health conditions like diabetes. This type of surgery may help lower your OSA severity, but many people still need OSA treatment after the procedure.
When to Talk to Your Doctor
Whether you already have a sleep apnea diagnosis or you suspect you may have the condition, talk to your doctor if you have new or worsening sleep apnea symptoms. These could include:
- Pauses in breathing while you sleep
- Loud snoring throughout the night
- Waking up gasping for air
- Feeling very sleepy during the day
- Trouble focusing or reacting
- Dry mouth or headache when you wake up
A roommate or bed partner may be the first to notice symptoms like snoring and gasping. Getting a diagnosis and finding effective treatment is important, because untreated sleep apnea can lead to complications like:
- Heart disease and rhythm problems
- High blood pressure
- Stroke
- Type 2 diabetes
- Gastroesophageal reflux disease (GERD)
- Kidney disease
If you already use sleep apnea treatment, like CPAP, but you still have symptoms, let your doctor know. They may recommend a repeat sleep study to determine if your treatment needs to be adjusted because of weight loss or other factors.
Frequently Asked Questions
Sleep apnea doesn’t cause weight loss. In fact, this sleep disorder can promote weight gain by disrupting your sleep and changing how your body responds to hunger hormones like ghrelin and leptin.
Treating sleep apnea can help regulate the factors that cause weight gain with the condition. But some people experience weight gain when they use a CPAP machine.
Studies show that the more weight you lose, the better your sleep apnea gets — up to a point. One review found that every 10% decrease in BMI was associated with a reduction in AHI of more than 20%.
For example, if you weighed 250 pounds and had an AHI of 30, losing about 25 pounds could potentially lower your AHI to around 24 or less. Losing additional weight may lead to further improvement, but the effect appears to become smaller once BMI has decreased by more than about 20%.
It’s important to note that while weight loss can substantially reduce sleep apnea severity, there’s no specific amount of weight loss that guarantees OSA will completely go away.
Yes, you can have sleep apnea at any weight. Obesity increases your risk for obstructive sleep apnea, but the condition also has other risk factors, like a large tongue or tonsils, a narrow airway, or health conditions that cause central sleep apnea.
Medical Disclaimer: This content is for informational purposes only and isn't a substitute for professional medical advice. Consult your healthcare provider with questions about any symptoms you're experiencing or before changing or stopping an existing treatment.
Written by
Abby McCoy, RN, Contributing WriterAbby McCoy is an experienced RN who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She holds a Bachelor’s of Science in Nursing from St. Louis Univeristy and has practiced nursing all over the world from San Francisco, CA, to Tharaka, Kenya. She now writes health content for trusted health outlets like Everyday Health and Next Avenue.
