Sleep Apnea Treatment Paradoxically Causes Weight Gain in Some Patients
Translated & summarized from Globes by baba
A new study by Professor Ariel Tarasiuk reveals that treating sleep apnea can paradoxically cause weight gain in some patients by altering appetite-regulating hormones and creating a persistent metabolic "memory." While sleep apnea itself may burn more calories, patients compensate by overeating, a habit that persists even after treatment. However, 30%-40% of patients actually lose weight after treatment, and emerging obesity drugs like GLP-1 agonists may offer a dual solution for weight and sleep apnea.
The story in 5 lines · by baba
- Treating sleep apnea can paradoxically cause weight gain in some patients, a new study suggests.
- The phenomenon is linked to hormonal changes that increase appetite and create a metabolic "memory."
- Mice in the study continued to overeat and gain weight even after their simulated sleep apnea was treated.
- While some patients gain weight, 30%-40% of sleep apnea patients actually lose weight after treatment.
- New obesity drugs targeting hormones may offer a combined treatment for weight gain and sleep apnea.
A new study led by Professor Ariel Tarasiuk from Ben-Gurion University of the Negev and Soroka Medical Center has investigated why treating sleep apnea can paradoxically lead to weight gain in some individuals. Sleep apnea, characterized by breathing cessations and frequent awakenings during sleep, is worsened by obesity, which in turn is exacerbated by the condition. Patients with sleep apnea often experience fatigue, reduced activity, and increased insulin resistance, leading to a vicious cycle of weight gain. While it was previously hypothesized that sleep apnea itself burns more calories due to breathing effort and awakenings, leading to compensatory overeating during the day, the new research delves into the underlying metabolic mechanisms.
Tarasiuk's research, conducted on mice, simulated sleep apnea and then treated it. The study found that even after treatment, the mice continued to overeat and gain weight. This phenomenon was linked to hormonal changes, including increased appetite-stimulating hormones like ghrelin and neuropeptide Y, and a decrease in the satiety hormone leptin during the apnea period. Even after treatment, leptin levels did not sufficiently curb the increased eating, suggesting a potential leptin resistance or insufficient effect.
The study also highlighted the role of orexin, a neuropeptide involved in maintaining wakefulness and regulating breathing, which also stimulates appetite. Furthermore, the research indicated that the metabolic system's "memory" of the apnea period persists, affecting glucose balance even after breathing normalizes. "The demon does not return to the bottle," Tarasiuk stated, referring to the difficulty in resetting the metabolic state.
However, not all patients experience weight gain. Professor Giora Piller from the Technion and Carmel Medical Center noted that current data suggests 30%-40% of sleep apnea patients treated with air masks actually lose weight due to increased alertness and activity. Only about 10% experience weight gain, likely due to the mechanisms described by Tarasiuk. Medical recommendations now include informing patients about potential weight effects and encouraging increased physical activity to leverage their newfound alertness.
Emerging treatments for obesity, such as the GLP-1 based drug semaglutide (found in Wegovy and Ozempic) and tirzepatide (Mounjaro), have shown promise in improving sleep apnea and aiding weight loss. Tarasiuk suggests that future treatments targeting this metabolic "memory" might need to focus on the endocrine system.