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Diet changes can improve sleep apnea, even without weight loss

Healthy habits during the day can lead to remarkable improvements in the quality of your nightly sleep

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Every night, millions of people lose sleep because of obstructive sleep apnea, a chronic disorder that causes periodic disruptions in nighttime breathing.

But a growing body of research suggests that improving your eating habits by cutting out ultra-processed foods, cutting back on alcohol and increasing your daily steps can reduce symptoms of sleep apnea and potentially even eliminate it.

The findings are important because sleep apnea is one of the most common causes of bad sleep, affecting an estimated 1 in 5 people worldwide. The condition occurs when the muscles in the back of your throat relax and block your airway as you’re sleeping, causing you to stop breathing. These apnea episodes can last for more than 10 seconds and occur many times a night, leading to gasping, snoring and frequent, abrupt awakenings as your body struggles for air.

Because of the heavy strain it puts on your body, sleep apnea can raise your blood pressure and increase your risk of developing diabetes and heart disease.

Obesity is a particularly strong risk factor because excess tissue in the mouth and throat can block your airway at night. But the new research shows that lifestyle and diet changes can reduce sleep apnea, even if you don’t lose weight.

In one recent study published in JAMA Network Open, researchers in Spain recruited 89 overweight and obese men who had moderate to severe sleep apnea and split them into two groups. One underwent a simple diet, exercise and lifestyle intervention. The participants were counseled to eat more healthy 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 sugar-sweetened beverages.

“It wasn’t a restrictive, low-calorie diet,” said Almudena Carneiro-Barrera, the lead author of the study and a researcher at Loyola University Andalusia in Spain. “We just taught them how to eat a healthy diet.”

The participants were encouraged to reduce their nightly alcohol consumption, and those who smoked were urged to stop. They were also advised to increase their daily step count by 15 percent a week.

The second group of participants, meanwhile, served as controls: They did not receive the lifestyle intervention.

Participants in both groups used a medical device called a CPAP machine, which delivers a gentle and steady flow of pressurized air through a tube and a mask that users wear while they sleep. CPAP is the standard treatment for sleep apnea. It prevents apnea episodes, but it can be uncomfortable, and many people stop using it or struggle to keep it on at night.

After just eight weeks, the group that adopted healthier habits had a 51 percent reduction in the number of apnea episodes they experienced during each hour of nightly sleep. About 15 percent achieved complete remission of their sleep apnea, and 45 percent no longer needed their CPAP machines.

On average, the healthy habits group lost about 16 pounds — roughly 7 percent of their body weight. By six months, they had sustained their weight loss, and the number of participants whose sleep apnea went into remission doubled. Roughly 62 percent of them no longer needed their CPAP machines.

They also had significant reductions in blood pressure, which, according to the researchers, lowered their risk of dying from a stroke or heart disease by more than 30 percent.

By comparison, the control group lost on average less than a pound of body weight and had little or no improvement in the severity of their sleep apnea.

“The results were far better than we expected,” Carneiro-Barrera said. She and her colleagues are now recruiting 500 women with sleep apnea for a larger, follow-up study.

Improvements without weight loss

Carneiro-Barrera noted that even people who did not lose much weight on the lifestyle program still saw reductions in the severity of their sleep apnea.

There could be many reasons for this. Sleep apnea has been linked to chronically high levels of inflammation. But a healthy diet and physical activity can reduce the amount of inflammatory substances circulating in your blood, said Susan Redline, a senior physician at the Brigham and Women’s Hospital and a professor of sleep medicine at Harvard Medical School who has 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 the participants experienced improvements in their sleep apnea regardless of whether they lost weight.

A randomized trial published in July showed that a paleo diet rich 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 sleep apnea. The diet they followed restricted dairy products, cereals and foods with added salt or sugar and refined fats like corn and soybean oil.

Cutting back on how much alcohol you drink in the evening can improve your sleep because alcohol reduces muscle tone in your throat, making your airway more likely to collapse as you sleep. One meta-analysis found that high levels of alcohol consumption increased the risk of sleep apnea by 25 percent.

Studies show that regular exercise can also ease sleep apnea symptoms because it prevents fluid from accumulating in your neck and constricting your airway at night.

So how do you know if you have sleep apnea? Some telltale signs are loud snoring, abrupt awakenings at night and waking up in the morning with a dry mouth, sore throat or a headache. If you have a bedmate, they may notice you gasping or choking in your sleep. Fatigue, irritability and daytime sleepiness are common signs as well.

If you suspect you do have sleep apnea, contact a doctor or a sleep medicine specialist. They can schedule you for a sleep test that can be done at home or in a lab. “Unfortunately, untreated sleep apnea is very common in the population,” Redline said.

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