Weight and sleep health in OSA: exploring their link

Weight loss is often recommended for individuals with obesity and OSA, however, weight loss is particularly hard for this population. This study investigates how weight and weight change are associated with sleep health in people with OSA.

Sleep data were analyzed from participants (n = 28) newly diagnosed with OSA over 12-months during which time they underwent a 6-month weight-loss intervention in a step-wedge design. Sleep duration, sleep regularity, and sleep efficiency were calculated for each participant based on Fitbit data. Linear mixed-effects models were used to examine the relationships between each sleep variable and weight and weight change over the intervention period.

Participants were middle-aged (51 ± 10 years), living with obesity (32.6 ± 4.4 kg/m²), and severe OSA (AHI 30.5[26.6, 49.8] events/h). There was no association between changes in weight and sleep duration or sleep efficiency. The higher an individual's weight (kg), the more likely they were to have irregular sleep (estimate = 0.81, 95% CI [0.29, 1.32] min, and p = 0.002). Conversely, weight changes (kg) were not associated with changes in sleep regularity (estimate = -0.10, 95% CI [-1.51, 1.31] min, and p = 0.884).

Higher weight was associated with worse sleep regularity. However, weight change was not associated with improvements in sleep regularity. Our findings demonstrate an association between weight and poor sleep in people with OSA, but the relationship is likely complex.