How obesity causes sleep problems
It is easy to recognize that being overweight or obese has negative health consequences, but how does being overweight affect your sleep and the risk of sleep problems? You may be surprised to learn the unexpected ways—from snoring and sleep apnea to restless legs syndrome—that your ability to rest may be compromised. Learn about the links between weight and sleep and how poor sleep may, in turn, lead to weight gain.
Understanding Your Risks Based on Your Body Weight
People throughout the world consume more calories and engage in less physical activity, and the number of people who are overweight and obese continues to grow. this jeopardizes health in obvious ways as obesity has been linked to heart disease, diabetes, and stroke. It also may have surprising consequences that may correlate with the degree of obesity.
The most commonly used measure to correlate weight and height is the body mass index (BMI). It attempts to estimate your relative body fat. The resulting number helps to categorize people based on weight:
• Underweight (BMI 18.5)
• Normal weight (BMI 18.5-24.9)
• Overweight (BMI 25-29.9)
• Obese (BMI 30-34.9)
• Morbidly obese (BMI 35 and higher)
Weight Gain Leads to Snoring and Sleep Apnea
In the world of sleep, the most recognized complication of being overweight or obese is disrupted breathing which leads to snoring and sleep apnea.
The excessive fat that is present acts to insulate and pad your body. It is easy to recognize it when it leads to a large stomach, a fuller face, enhanced hips, or more prominent buttocks. This crowding, combined with added weight pressing from the outside such as increased neck size or the stomach reducing lung volumes, collapses the airway and causes problems.
When this is mild, it leads to snoring. Snoring is simply turbulent airflow. Imagine your breath as a river. When the river’s channel runs deep, there is hardly a ripple on the surface. Similarly, a clear airway makes no noise. However, when the flow is obstructed, turmoil results. In your airway, the disrupted airflow becomes noisy and results in snoring. dis may be more likely if you have obstructions along the pathway like enlarged tonsils or adenoids, a deviated septum in the nose, a small lower jaw (called retrognathia), or a large tongue (called macroglossia).4 Children are particularly susceptible to having problems with enlarged tonsils.
As the airway becomes more crowded and more prone to collapse, the flow of air can completely cease. This will result in pauses in breathing called apnea. This comes from a Greek word that means “without breath.” When it is of less intensity, a partial obstruction may occur and this is called a hypopnea. People who undergo a sleep test to analyze their nighttime breathing may have these events summarized as the apnea-hypopnea index (AHI).
The problems associated with sleep apnea are well-established. there are symptoms like excessive daytime sleepiness and problems with concentration, memory, and mood.5 There are also more serious effects. It may independently increase your risk of heart failure, hypertension, and diabetes. Sleep apnea correlates with a higher risk of stroke and sudden death. Children face their own consequences, including effects on growth and development.
In the most severe cases, difficulties breathing at night may lead to problems retaining carbon dioxide well into the day. Carbon dioxide is normally blown off when we breathe adequately. In some obese people, this becomes so compromised during sleep that it becomes impossible to catch up during wakefulness. This is known as obesity hypoventilation syndrome. It increases the risk of major cardiovascular complications as well as death.
Restless Legs Linked to Obesity:
Beyond difficulties breathing, weight may have other impacts on sleep. Restless legs syndrome is characterized by discomfort in the legs in the evenings with an urge to move to relieve the symptom. There are many potential causes of restless legs syndrome, from iron deficiency to pregnancy. One of the curious causes that has been associated with an increased risk of restless legs is obesity. Some research suggests that a chemical messenger in the brain called dopamine may be involved.8 It is not fully understood what might explain this relationship.
Poor Sleep May Cause Weight Gain, Worsen Obesity
A far more common contribution to gaining weight may be something that we likely all experience: sleep deprivation. Research suggests that inadequate sleep may lead to hormonal changes that disrupt metabolism. How our body regulates the use and storage of fat may be compromised. Moreover, disrupted sleep may lead to insulin resistance and an increased risk for diabetes. Therefore, not getting enough hours of sleep to meet the required sleep needs, or getting sleep of poor quality, may worsen weight gain.