5 Proven Strategies to Lose Weight If You Have Sleep Apnea

Erica was a young woman who I saw yesterday for sleep apnea. She commented to me that despite eating healthy meals, limiting her calorie intake, and exercising regularly, she’s still gaining weight. This seems to be a very common problem for many people today, whether or not you have obstructive sleep apnea. Although it’s been shown that you can still have sleep apnea even if you’re thin, the vast majority of people in the United States with sleep apnea are overweight. A JAMA article in 2012 estimated that about 35% of Americans are obese (BMI > 30), and 69% are considered overweight or obese (BMI > 25).

Here are 5 proven strategies to lose weight, wether or not you have obstructive sleep apnea:

1. Sleep longer

Study after study reveals that the shorter you sleep, the more pounds you’ll pack on. In general, sleeping less than 6 hours per night is associated with being much heavier. This effect was found to be more important in younger people in a study by Patal and Hu from Case Western and Harvard Universities. In fact, a number or studies show a U-shaped pattern, with higher rates of obesity with too little or even too much sleep. Ohkuma and colleagues from Kyushu University found that in type 2 diabetics, excessively short and long sleepers where found to be more obese, as well as having higher levels of hemoglobin A1c (a marker of poor diabetes control). 

Americans now sleep on average of 6.8 hours per night, which is about one hour less than what we used to get in the 1940s. Today, about 40% of people get less than 7 hours of sleep. In an unscientific study by Glamour Magazine, 7 overweight readers were asked to sleep for 7.5 hours  every night, without making any other changes to their diet or exercise routines. After 10 weeks, 6 women lost on average over 8 pounds, with a range between 6 to 15 pounds. One woman who was only partially able to follow the recommended sleep schedule didn’t lose any weight, but she did lose 2.5 inches off her waist, bust and hips.

2. Don’t eat anything within 3-4 hours of bedtime

I may sound like a broken record, but this is the single most important piece of advice I give to all my patients. Having extra stomach juices due to a late night snack will predispose to regurgitation into your throat, causing more swelling and more obstructed breathing. It’s not only acid that’s coming up, but also includes bile, digestive enzymes and bacteria. It’s also been shown that these juices can reach your sinuses and ears, as well as go down to your lungs, causing major inflammation. If you normally don’t eat late, then this won’t apply to you, but if you’re a late snacker, this is the single most important step to take if you want to breathe better, sleep better, and begin to lose weight. 

I know some of you are going to tell me that this is impossible. You’re so hungry a few hours after dinner, or you get home really late after work so it’s not even an option. This is understandable, since we know that poor sleep will cause you to be hungry and you will preferential crave sugary, fatty or starchy foods. Poor sleep in general is known to to lower leptin, a hormone made by your fat cells telling you that you’ve had enough food. Obese people are found to be leptin resistant. Poor sleep also raises ghrelin, a hormone made in your stomach that makes you more hungry.

What patients tell me is that despite being difficult in the beginning, once you get started, it gets easier and easier, since better quality sleep will make you less hungry and less likely to crave unhealthy foods during the day. In general, eating an early, healthy dinner using ingredients with a low glycemic index will prevent you from being hungry 3 hour after dinner. Listen to nutritionist Maria Alexandra Bella‘s advice on how to avoid getting hungry after dinner. Instead of just trying harder, have a plan of action.

3. Don’t drink alcohol close to bedtime

Many people know not to drink alcohol close to bedtime, since it ruins their sleep quality. But some people enjoy their night caps since it helps them to relax and fall asleep faster. The problem is that alcohol is not only a sedative, it also relaxes your throat muscles. Alcohol may help you to fall asleep better, but it will definitely cause more apneas and arousals, leading to significantly worse sleep quality. Red wine, in particular, has additional properties that can aggravate migraines and headaches. 

4. Keep your nose clear and open

One major reason why I emphasize good nasal breathing is based on a old study showing that a combination of a nasal decongestant and a pill to help empty the stomach lowered snoring levels significantly. This is also why I’m against eating close to bedtime. Since so many people with strong and sleep apnea have nasal congestion to various degrees, it’s important to make sure that you’re able to breathe fully through your nose. Many people who are chronic mouth breathers deny that they have nasal congestion, since they don’t know what normal nasal breathing is. Whenever I spray a decongestant and lift up the nostrils, oftentimes the patient has  a WOW experience. Whether you need to treat any allergies, use saline irrigation, use nasal dilator strips, or even undergo surgery, do whatever it takes to breathe better through your nose. Read my free e-book, “How to Unstuffy Your Stuffy Nose,” for more helpful tips.

5. Exercise outdoors

This recommendation is probably the most anecdotal, but there’s value to exercising outdoors. A few years ago, I saw a middle-aged overweight woman who came to see me for her sinus problems, chronic fatigue, and headaches. I recommended addressing her allergies, but also to avoid eating late and to exercise outdoors in the sunlight. After 6 months, she emailed me saying that her life was changed completely: She began jogging outdoors in the mornings, lost 30 pounds, and recently ran the New York City Marathon. She has much more energy and no more headaches.

My rationale for exercising outdoors is that most modern people don’t get enough sunlight exposure to create healthy levels of Vitamin D. Yes, we do get some Vitamin D though our food sources, but not enough to maintain healthy levels. It’s important to realize that Vitamin D is not just a vitamin to help develop strong bones. Rather, it’s a hormone that has important effects on your entire body, from your brain to your metabolism. There are lots of studies showing a strong association between low D levels and obesity. For a fascinating discussion about the importance of Vitamin D, listen to my interviews with Dr. Stasha Gominak.

Make a goal to start losing weight today

Before you invest in a gym membership or start up a new diet regimen, it’s extremely important to make sure you’re getting an adequate quantity of quality sleep. Otherwise, your results from exercising or dieting won’t work as well or won’t work at all. If you have obstructive sleep apnea or upper airway resistance syndrome, getting 8 hours of sleep won’t make much of a difference, since the quality of your sleep will suffer greatly. Regardless of whether or not you have sleep-breathing problems, the 5 steps I’ve outlined above should be the basic health foundation for everyone. 
If you’re having trouble losing weight, make a commitment to try these 5 steps for 4 weeks. Write down your goal as a SMART goal (specific, measurable, actionable, realistic, timely). Also, write down 5 consequences of not taking action and 5 positive outcomes or benefits of achieving your goal. Please come back to this blog and give us feedback on how you did. 


Please note: I reserve the right to delete comments that are offensive or off-topic.

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