Sleep disorders and obesity: A vicious cycle

By Zaiba Jetpuri, D.O. and
Safia Khan, M.D.

Sleeping troubles and obesity are linked, so correcting conditions such as sleep apnea could be an important step toward weight loss.

The health effects of sleep disturbances are well-documented, from recent news reports stating that getting 7-8 hours of good sleep nightly may decrease cardiovascular risk by 75% to tragic reports of fatigued drivers falling asleep at the wheel. In June 2022, the American Heart Association added getting better sleep to its list of top heart-healthy behavioral factors.

The implications of chronic obesity are also well-documented, as the condition has been associated in many studies with an increased risk of disorders such as Type 2 diabetes, high blood pressure, nonalcoholic fatty liver disease, and depression What might surprise people is just how closely the health epidemics of obesity and chronic sleep problems are linked.

Obesity can cause sleep disturbances, which in turn influence weight gain through reduced energy levels and biological hardwiring that floods the body with stress hormones.

But perhaps the most frustrating part of this vicious cycle is that poor sleep can be lifesaving in certain circumstances for people with obesity. When breathing is disrupted or when our legs unexpectedly twitch, the body releases stress hormones and quickens the heartbeat to wake us up. While this defense mechanism keeps patients breathing, it prevents deeper, restorative sleep and floods the body with chemicals that drive us to retain energy stores instead of burning them.

In the U.S., more than 40% of people have obesity and about 21% of people have a sleep disorder. Nationally, over 70% of patients with obstructive sleep apnea, a common and potentially fatal sleep and breathing disorder, also have obesity.

Sleep and obesity are intertwined in a vicious cycle. Obesity can cause sleep disturbances, and sleep disturbances can influence weight gain through the release of stress hormones.

Safia Khan, M.D.

So, because sleep disorders and obesity are so common, where do we start in helping patients improve their health?

While there is no single chick-en-or-egg scenario, we observe in our Family Medicine and Sleep and Breathing Disorders clinics that by the time a patient starts having sleep problems, they have already started to become overweight or developed obesity. Troubled sleeping is often what brings them to the doctor – on their own or at the request of a bed partner who is fed up with loud snoring.

Also often, correcting sleep issues is the quickest win for patients, and that is where we start. But the key to long-term health is to help the patient understand what caused their sleep disturbance and weight management concerns in the first place –and to equip them with information to reduce hormonal, chemical, and cardiovascular risks associated with these dual epidemics.