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The Link Between Obesity and Sleep Problems

Medically Reviewed by Brunilda Nazario, MD on June 16, 2021

If you’re overweight or obese, you’re at a higher risk for sleep problems, compared to people at a healthy weight. You’re considered overweight if you have a body mass index (BMI) of 25 to 29. People who are obese have BMIs of 30 or higher. (Your doctor can help you figure out your BMI and whether you’re carrying extra weight.)

What’s the Relationship Between Sleep and Weight?

You may have a hard time getting the rest you need if you’re overweight or obese for several reasons. For starters, experts say extra body fat may impact sleep-wake cycles and metabolism. And excess body fat can put pressure on your neck, especially when you’re lying down. Some people who are overweight have an increase in soft tissue in the airway, which can lead to conditions like snoring and obstructive sleep apnea (OSA).

People who are obese are more likely to have insomnia, which is when you can’t fall or stay asleep. They’re also more likely to be sleepy and exhausted during the daytime, even if they’ve never noticed sleep issues like waking up in the middle of the night.

People who are obese are seven times more likely to have OSA, a sleep disorder that causes your airway to be partially or fully blocked. That can cause you to snore and temporarily stop breathing. OSA can make you feel exhausted during the day, even if you think you’re sleeping through the night. And it ups your odds of other serious conditions, like heart disease.

You’re also more likely to have gastroesophageal reflux disease (GERD) if you’re overweight or obese. GERD is when food and stomach acid leak back into your esophagus. It can cause heartburn, including at night, which can disrupt your sleep.

Being overweight increases the odds you’ll get other sleep-disrupting health conditions like osteoarthritis (when joint-protective cartilage gets worn down, causing pain) and asthma (when your airways become inflamed, making it difficult to breathe).

How to Sleep Soundly

If you’re overweight and have trouble sleeping, that can actually lead to more weight gain. And that, in turn, can make it harder to sleep. If you’re exhausted, you’re less likely to exercise, and more likely to make poor food choices. Sleep deprivation and poor-quality sleep also disrupt levels of hunger-regulating hormones called leptin and ghrelin, which can cause you to eat more.

You can break the cycle. Start by telling your doctor if you’re sleeping poorly or are tired all the time. In addition to lifestyle changes that can help you shed pounds, your doctor may recommend you get tested for sleep disorders like OSA. If you do have OSA, a continuous positive airway pressure (CPAP) machine may help you sleep better. And that can help you lose weight. Also, treating GERD through lifestyle changes and medications can improve your sleep.

If you have insomnia but don’t have another sleep disorder, consider trying cognitive behavioral therapy for insomnia (CBTI). CBTI is a type of talk therapy that teaches you to ease your mind, so you can fall asleep faster and stay asleep longer. Research shows it can work better than sleep medications, which can cause side effects like next-day drowsiness. And getting regular exercise can help you lose weight and improve the quality of your sleep, even if you have a sleep disorder like OSA. Exercise can improve your metabolism, and if you exercise outside, you’ll be exposed to natural light, which may improve your sleep-wake cycle.

Show Sources

SOURCES:

Sleep Foundation: “Obesity and Sleep.”

Harvard T.H. Chan School of Public Health: “Sleep,” “Waking Up to Sleep’s Role in Weight Control.” 

Johns Hopkins Medicine: “Seven Ways to Get a Healthier Night’s Sleep,” “The Dangers of Uncontrolled Sleep Apnea.”

American Journal of Respiratory and Critical Care Medicine: “Effect of Weight Loss on Upper Airway Anatomy and the Apnea-Hypopnea Index. The Importance of Tongue Fat.”

Journal of Physiotherapy: “Exercise Training Improves Sleep Quality in Middle-Aged and Older Adults with Sleep problems: A Systematic Review.”

Kimberly Truong, MD, founder, Early Bird Health, Southern California; assistant clinical professor of medicine, University of California, Irvine.

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