The findings are important because sleep apnea is one of the most common causes of poor sleep, affecting approximately 1 in 5 people worldwide. The condition occurs when the muscles at the back of your throat relax and block your airways while you sleep, making it difficult for you to breathe. These apneic episodes can last longer than 10 seconds and occur several times a night, resulting in frequent, abrupt gasping, snoring, and waking up as your body struggles to breathe.
Obesity is particularly strong risk factor because excess tissue in the mouth and throat can block your airways at night. But new research shows that lifestyle and diet changes can reduce sleep apnea, even if you don’t lose weight.
In a recent study published in JAMA Network Open, Spanish researchers recruited 89 overweight and obese men with moderate to severe sleep apnea and divided them into two groups. One underwent a simple diet, exercise and lifestyle intervention. Participants were advised to eat healthier whole foods such as fruits, vegetables, beans, olive oil, seafood, poultry, eggs and herbs. They were also encouraged to avoid ultra-processed foods, processed meats, salty snacks and sugary drinks.
“It wasn’t a restrictive, low-calorie diet,” said Almudena Carneiro-Barrera, the study’s lead author and researcher at Loyola University of Andalusia in Spain. “We just taught them to eat healthy.”
Participants were encouraged to reduce their nighttime alcohol consumption and those who smoked were asked to quit. They were also advised to increase their daily step count by 15% per week.
The second group of participants, meanwhile, served as a control: they did not receive the lifestyle intervention.
Participants in both groups used a medical device called a CPAP machine, which delivers a gentle, steady stream of pressurized air through a tube and mask that users wear while sleeping. CPAP is the standard treatment for sleep apnea. It prevents apnea episodes, but it can be uncomfortable, and many people stop using it or have trouble keeping it on at night.
After just eight weeks, the group that adopted healthier habits experienced a 51% reduction in the number of apnea episodes they experienced during each hour of nighttime sleep. About 15% achieved complete remission of their sleep apnea and 45% no longer needed their CPAP devices.
On average, the healthy habits group lost about 16 pounds, or about 7% of their body weight. After six months, they had maintained their weight loss, and the number of participants whose sleep apnea was in remission had doubled. About 62% of them no longer needed their CPAP machines.
They also had significant reductions in blood pressure, which the researchers said reduced their risk of dying from stroke or heart disease by more than 30%.
By comparison, the control group lost an average of less than a pound of body weight and had little to no improvement in the severity of their sleep apnea.
“The results were much better than we expected,” Carneiro-Barrera said. She and her colleagues are currently recruiting 500 women with sleep apnea for a larger follow-up study.
Improvements without weight loss
Carneiro-Barrera noted that even people who didn’t lose much weight from the lifestyle program still saw a reduction in the severity of their sleep apnea.
There can be several reasons for this. Sleep Apnea was bound to chronically high levels of inflammation. But healthy eating and physical activity can reduce the amount of inflammatory substances circulating in your blood, said Susan Redline, chief medical officer at Brigham and Women’s Hospital and professor of sleep medicine at Harvard Medical School. who studied diet and its link to sleep apnea.
Studies show that different diets can work. In a recent study, a group of overweight men and women improved their sleep apnea and experienced less insomnia and daytime sleepiness by following a Mediterranean diet rich in fish, whole grains, plants and foods high in unsaturated fats. The study found that participants experienced improvements in their sleep apnea whether or not they lost weight.
A randomized trial published in July showed that a paleo diet high in lean meat, fish, eggs, fruits, vegetables, berries, nuts, avocado and olive oil helped a group of overweight women lose weight and reduce the severity of their apnea sleep. The diet they followed limited dairy products, grains, and foods with added salt or sugar and refined fats like corn and soybean oil.
Reducing the amount of alcohol you drink at night can improve your sleep because alcohol reduces muscle tone in your throat, making your airways more likely to collapse while you sleep. A meta-analysis found that high levels of alcohol consumption increased the risk of sleep apnea by 25%.
Studies show that regular exercise can also relieve symptoms of sleep apnea because it prevents fluid from building up in your neck and constricting your airways at night.
So how do you know if you have sleep apnea? Some telltale signs are loud snoring, waking up suddenly at night, and waking up in the morning with a dry mouth, sore throat, or headache. If you have a bedmate, they may notice you panting or choking in your sleep. Fatigue, irritability and daytime sleepiness are also common signs.
If you suspect you have sleep apnea, contact a doctor or sleep medicine specialist. They can schedule you for a sleep test which can be done at home or in a lab. “Unfortunately, untreated sleep apnea is very common in the population,” Redline said.