Today, let’s look into a frequently overlooked and misunderstood aspect of our well-being: the link between obstructive sleep apnea (OSA) and weight gain. While it’s simple to blame a few extra pounds on lifestyle factors such as work-life balance, stress, challenges in preparing nutritious meals, or limited time for exercise, we may overlook a crucial element: the quality of our sleep.

Cross-sectional studies have found an association between increased body weight and the risk of OSA.  Significant sleep apnea is present in approximately 40% of obese individuals and approximately 70% of OSA patients are overweight. But which comes first?  Well, this varies among individuals.  In some cases, we see weight gain precede the development of sleep-disordered breathing and in others, OSA can cause weight gain over time.

But what about the folks with poor sleep who seem fit?  They are less likely to seek a diagnosis for sleep disorders due to the misconception that only overweight individuals can suffer from sleep apnea.  If we look at the numbers, approximately 30% of people diagnosed with OSA are otherwise healthy, fit and have a normal BMI.  

Signs of sleep apnea include loud snoring, gasping or choking sound during sleep, excessive daytime sleepiness, morning headaches, irritability, difficulty concentrating, and waking up with a dry mouth or sore throat.  Even individuals at a healthy weight should be mindful of these symptoms as sleep apnea can result from various other factors such as anatomical abnormalities, genetic predisposition, or lifestyle habits.  If you think you have a sleep disorder it is important to reach out to your health care provider.  

In this blog, we will focus on the link between OSA and weight gain and the key factors contributing to this relationship.  As well as, strategies to help manage weight.  

How does Obstructive Sleep Apnea affect weight gain?

Hormonal Changes: Have you ever had that bottomless, can-not-get-full feeling after a late night? Poor sleep and OSA can disrupt the body’s hormonal balance, particularly the appetite hormones, such as ghrelin and leptin. Ghrelin, the hunger hormone, increases with insufficient sleep, while leptin, which signals satiety, decreases. This imbalance can lead to increased feelings of hunger and overeating.  

Increased Appetite: Sleep deprivation and OSA are associated with increased cravings for high-calorie, high-carbohydrate foods. This may be a result of the body seeking quick sources of energy to combat fatigue and exhaustion caused by poor sleep.   Do you find yourself reaching for a quick hit of sugar and caffeine in the afternoon?  Double-double and a timbit, anyone?

Energy Expenditure: Lack of quality sleep or interrupted sleep due to OSA can lead to decreased energy levels and reduced physical activity. People may feel too tired or lethargic to exercise, leading to a decrease in overall calorie expenditure.  If you subscribe to the calories in, calories out theory, this is a recipe for disaster.

Metabolic Changes: Do you have Type 2 Diabetes?  Chronic sleep deprivation and OSA have been linked to metabolic dysregulation, including impaired glucose metabolism and insulin resistance. These metabolic changes can contribute to weight gain and difficulty in losing weight.

Disruption of Circadian Rhythms: Poor sleep quality can disrupt the body’s internal clock, known as the circadian rhythm. Disrupted circadian rhythms have been associated with metabolic disturbances and weight gain.  It’s a vicious cycle, poor sleep throws off our circadian rhythm and when those rhythms are off, it’s harder to fall asleep and stay asleep when we need it most. 

Stress and Cortisol: Sleep deprivation can increase stress levels and activate the body’s stress response, leading to elevated levels of cortisol, a hormone associated with weight gain, particularly in the abdominal area.  High levels of cortisol make sleeping through the night much more difficult, you can blame cortisol for those 3:00 am wake-up calls!

Snacking and Late-Night Eating: People experiencing poor sleep quality may be more prone to late-night snacking or eating due to increased wakefulness during the night or irregular eating patterns.  Resist the temptation to eat late at night, eating within 3 hours of bedtime can significantly disrupt sleep.

Changes in Gut Microbiota: Emerging research suggests that disruptions in sleep patterns and OSA may alter the composition of gut microbiota, which can influence metabolism and weight regulation.

Overall, the combination of hormonal changes, increased appetite, decreased energy expenditure, metabolic alterations, and disrupted circadian rhythms can contribute to weight gain over time. Addressing sleep issues and improving sleep quality may be an important component of weight management strategies for anyone struggling with obesity or weight gain.

Can you lose weight if you have OSA?

Yes, you can.  However, losing weight can be particularly challenging for people with OSA.  A comprehensive approach to weight management and OSA treatment can lead to successful weight loss and improved sleep.  Consider these strategies:

Seek Treatment:  Prioritize the diagnosis and treatment of OSA to improve your sleep quality and address underlying causes of weight gain.  Continuous positive airway pressure (CPAP) therapy is a highly effective treatment option that works by keeping the airway open during sleep, reducing respiratory events, and alleviating daytime fatigue and sleep disturbances.  Don’t hesitate to explore CPAP therapy and other available treatments to reclaim your good night’s sleep and support your weight management goals.

Eat a Balanced Diet:  Focus on whole foods, including fruits and vegetables, lean proteins, healthy fats and whole grains.  Reduce the intake of processed and refined foods, sugary snacks and high-fat meals.  Pay attention to portion size and practice mindful eating to feel full faster and to control calorie intake. 

Keep Track:  Use tools such as a food journal or mobile app to track your meals, snacks and beverages – you might be surprised at what you see.  Once you know what you’re consuming you can make adjustments to help you achieve your goals.

Exercise Regularly:  Regular physical activity promotes weight maintenance, improves cardiovascular health and enhances our overall well-being.  Try a combination of aerobic exercises (walking, running, cycling) and strength training (weight training, resistance exercises) to build muscle mass and increase metabolism.  Pound for pound, muscle burns about three times as many calories as fat. If you are just starting or have not exercised for some time, consult your healthcare professional before starting a new routine.

Prioritize Quality Sleep: We should all aim for 7-9 hours of sleep per night and practice good sleep hygiene habits.  Limit screen time for at least one hour before bed, maintain a consistent sleep schedule and create a comfortable sleep environment.  Your bedroom should be cool, dark and quiet to promote the best rest possible.

Manage Stress:  Chronic stress can contribute to weight gain and disrupt sleep, so finding healthy ways to manage it is essential for achieving and maintaining weight loss and getting your best night’s sleep.  Try meditation, yoga, journaling or whatever makes you feel great.

Find Support:  Whether you turn to friends, family or healthcare professionals to help you stay motivated and accountable on your journey a little support and encouragement goes a long way.  

If you can integrate these strategies into your daily routine and address OSA and weight management simultaneously, you can increase your chances of achieving successful weight loss.  Remember to be patient with yourself, sustainable weight loss takes time and effort but the benefits will be so worth it in the long run.


Whether you’ve been struggling with unexplained weight gain or symptoms of OSA, seeking professional guidance can make a big difference in your wellness journey.  A consultation with a healthcare provider or sleep specialist can give you personalized insights, diagnostic assessments and tailored treatment options to address your specific needs.  Don’t hesitate to Book a Consult today and take the first step toward better sleep and overall wellness.  Your future self will thank you for it.