The Link Between Obesity and Sleep

Written by Natalie Grigson, Writer

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Can Poor Sleep Cause Weight Gain?

Yes, research suggests that regularly getting less than seven hours¹ of sleep can lead to weight gain. There are several reasons for this, the first of which is hormones². When somebody has trouble sleeping through the night or doesn’t get enough total sleep, the body either over or under-produces several hormones, including ghrelin, GHS-R, leptin, insulin, and cortisol.

Ghrelin is the hormone that stimulates appetite³. Increased production of ghrelin, often resulting from inadequate sleep, can enhance appetite. Conversely, insufficient sleep can reduce leptin production, a hormone that signals fullness.³

This impact on appetite-regulating hormones plus a lack of energy the next day can lead to increased snacking⁴, specifically on foods high in sugar and carbohydrates⁵.

Plus, sleep deprivation often results in feeling lethargic the following day, typically reducing energy levels and motivation to engage in physical activity.

Can Obesity Make Sleep Worse?

Being significantly overweight can impact sleep health in multiple ways.

First, research indicates⁶ that overweight or obese people have a heightened risk of developing obstructive sleep apnea (OSA). When we are overweight, excess fat is stored not only on the outside of the body but also internally, including the airways, throat, and abdomen. This creates less room for the lungs and diaphragm to expand, so often, the sleep issues we see with overweight people have to do with breathing. This can be the case with OSA when a blockage in the airway leads to periodic gaps in breathing during sleep⁷. Excess fat in the throat can lead to a blockage, potentially resulting in OSA symptoms.

Additionally, excess weight can contribute to physical pain⁸ and discomfort, including lower back pain, leg pain, and various musculoskeletal conditions. As you can imagine, this sort of chronic pain can be a major cause of insomnia as well as other sleep issues.

Common Sleep Issues in People Who are Overweight

Asthma

As mentioned earlier, being overweight or obese can harm the respiratory system. The American Lung Association highlights⁹ that being overweight or obese can exacerbate or contribute to the development of asthma. Additionally, they note that people with a BMI over 30 may experience reduced efficacy of asthma medications compared to those with a BMI under 30.

As far as sleep goes, this can mean worse sleep quality, difficulty going to sleep, waking up through the night, and increased daytime sleepiness.

Obstructive Sleep Apnea (OSA)

In the U.S., it is estimated that over 70 percent¹⁰ of patients with obstructive sleep apnea are also obese. Excess fat is also stored internally in the throat and airways. As the name implies, obstructive sleep apnea is caused by an obstruction of the airways, causing blood oxygen levels to drop quickly, resulting in the body jolting awake to resume normal breathing.

Learn more about this sleep disorder in our in-depth sleep apnea guide.

Snoring

With all of the respiratory issues that can come from being overweight, it is not surprising that overweight people are more likely to snore¹¹ at night. This can be problematic for couples sharing a bed, but even for solo sleepers, the snoring can be so loud that it may wake the sleeper.

Learn more about how snoring impacts sleep quality.

Gastroesophageal Reflux Disease (GERD)

Being overweight, especially when excess weight is concentrated in the abdomen, significantly increases the risk of developing gastroesophageal reflux disease (GERD)¹². This extra weight then puts pressure on your stomach and intestines, which can lead to more stomach acid traveling up into the esophagus. The result is heartburn, belching, chest pain, and other uncomfortable symptoms interrupting a good night’s sleep.

Restless Legs Syndrome (RLS)

Adults who are overweight or obese have a higher likelihood of experiencing restless legs syndrome¹³ compared to those who are not overweight. Restless legs syndrome—the uncontrollable desire to move your legs, often worse in the evening and at night during sleep—is associated with lower dopamine receptors in the brain. Obesity is also associated with lower dopamine levels in the brain, which scientists suggest may explain the connection¹⁴ between the two.

Explore our picks for the best mattress for restless leg syndrome.

Osteoarthritis

Carrying extra weight increases the risk of osteoarthritis and other musculoskeletal issues.⁸

This is because extra weight strains the bones, muscles, and joints on a mechanical and metabolic level. Plus, being overweight can increase the body’s overall level of inflammation, which is a key factor in osteoarthritis.⁸

The joint pain and discomfort caused by osteoarthritis can lead to sleep disturbances. According to the Arthritis Foundation, 70 percent¹⁵ of people with osteoarthritis live with some sort of sleep disturbance.

If joint pain disrupts your sleep, browse our best mattresses for arthritis.

How Sleep Deprivation Affects Body Weight

Impacts Appetite Hormones

Insufficient sleep leads to decreased production of leptin, the hormone that signals fullness, while simultaneously increasing ghrelin production, which stimulates appetite.³

As a result, you may wind up eating more, which could lead to weight gain.

Poor Diet Choices

Sleep deprivation significantly influences the types of foods you crave. According to a 2022 analysis of sleep loss and weight management studies, not getting enough sleep or consistently getting poor quality sleep can lead to increased snacking on foods high in fat and carbs, leading to weight gain.⁴

“Someone who is not sleeping well often reaches for sugary drinks and ready ‘fixes’ that nip hunger, boost blood sugar levels, and keep them alert,” says bariatric physician Dr. Kevin Huffman, MD. Research¹⁶ supports Dr. Huffman’s observation, showing that sleep deprivation can lead to cravings for sugary foods, influenced by changes in brain processing resulting from chronic sleep loss.

Less Physical Activity

There’s the obvious effect of sleep loss on physical activity — if you’re not getting enough sleep, chances are you simply don’t have the energy to exercise. Yet, it’s not just a matter of being too tired during the day.

Studies¹⁷ indicate that sleep loss can negatively affect exercise performance, potentially leading to weight gain if the reduced activity level isn’t enough to maintain current weight.

“Additionally, lower motivation and a general lack of energy can reduce total energy expenditure [or calories burned],” Huffman explains. “For one patient, once we treated his sleep apnea and he began sleeping well, he naturally took daily walks and entered the gym with increased energy.”

Body Temperature

While it’s unclear which factor comes first, newer research¹⁸ is slowly discovering a link between core body temperature, poor sleep, and obesity. Studies show that an elevated or high body temperature can interfere with sleep onset or falling asleep. This, in turn, can cause chronic sleep loss and certain eating behaviors like late-night eating, the data has found.

Slower Metabolism

As a critical function that helps convert food into energy, your metabolism plays an important role in weight management. Research¹⁹ demonstrates that chronic sleep deprivation can disrupt metabolic balance. As a result, your body changes how it releases hormones and regulates glucose, or blood sugar, leading to potential weight gain and even obesity.

“Lack of sleep can dampen your metabolism,” Huffman further explains. “Less sleep slows down your metabolism by promoting the release of stress hormones such as cortisol into your bloodstream. Extra stress hormones can affect metabolic processes and get in the way of your weight loss goals.”

“According to some studies, chronic sleep problems might also lead to insulin resistance, complicating weight management even further,” he adds.

Tips to Improve Sleep When Overweight

If you’re currently overweight, there are several things you can do to improve your sleep quality.

Practice good sleep hygiene – Sleep hygiene refers to our daily habits, routines, and the physical space where we sleep. There are many ways to improve your sleep hygiene, but some of the most important include: going to bed at the same time each night (including weekends), stopping screen time at least 30 minutes to an hour before bedtime, avoiding caffeine or alcohol late in the day, making sure your bedroom is dark, cool, and noise-free, and doing something relaxing before bedtime that helps you wind down.
Improve your diet and nutrition – Improving your diet and nutrition should help you lose weight, which should help you get better sleep in the long term. However, even in the short term, improving diet and nutrition can immediately impact how you sleep, as research shows that diets high in saturated fat and sugar and low in fiber lead to less restorative sleep²⁰.
Exercise—As with a healthy diet, exercise should help you lose weight and improve your sleep long-term. However, even in the short term, exercise has been shown to improve sleep²¹ by reducing symptoms of anxiety and depression and physically tiring the body out. If you exercise outdoors, you get the added benefit of sunlight to regulate your body’s natural circadian rhythm.
Find a great mattress—Often, getting better sleep is as simple as getting a mattress better suited to your body. Sleeping on a mattress that isn’t supportive can feel uncomfortable and cause or exacerbate back pain. Instead, a mattress for heavy people could help keep your body in better alignment and improve your sleep quality.

Find out more: 11 Tips to Improve Sleep Quality

Frequently Asked Questions

Is there a link between sleep disorders and obesity?

Research indicates that over 70 percent of people with obstructive sleep apnea are also obese. This association is likely due to the accumulation of excess fat in areas around the airways, not the lungs themselves.¹⁰

How does sleep affect metabolism and obesity?

Chronic sleep deprivation can disrupt your metabolism, impairing blood sugar regulation, which can be a precursor to weight gain.¹⁹

Can improving sleep help with weight loss?

Consistently obtaining good-quality sleep, between seven to nine hours per night, can aid in weight management, particularly in reducing fat.⁴

How does sleep affect metabolism?

Sleep deprivation can impair your metabolism, leading to poor glucose regulation and an increased risk of weight gain.¹⁹

What is sleep apnea obesity hypoventilation syndrome?

Obesity hypoventilation syndrome²² , often occurring with sleep apnea, involves a combination of obesity, sleep-disordered breathing, and daytime hypercapnia, with symptoms including headaches, shortness of breath, daytime fatigue, and confusion.

What is the best sleep position for obese people?

“When it comes to sleep positions, there is no one size fits all,” Huffman says. However, he adds that sleeping on your side can help alleviate any back pain from obesity.

Can obesity cause sleep apnea and sleep deprivation?

Yes, people who are obese are at an increased risk of developing obstructive sleep apnea, which could also impact their quality of sleep.⁶ Also, heavier people may experience more pain that can keep them up at night due to excess weight.⁸

Summary

Sleep is one of the most important aspects of our overall physical and mental health and well-being. If we’re not sleeping well, we’re not feeling well.

Unfortunately, being overweight seems to have a direct impact on how well we sleep, and how well we sleep also impacts how much we weigh. Because of this interdependent relationship, it is important to address the issue on both ends: maintaining a healthy weight as well as creating healthy sleep habits.

Getting to and maintaining a healthy weight can be a lifelong process, so in the meanwhile, we recommend improving your sleep while overweight, by implementing a healthy diet, regularly exercising, improving sleep hygiene, and of course, making sure you’re sleeping on the best mattress possible.

Natalie Grigson

Writer

About Author

Natalie is a content writer for Sleep Advisor with a deep passion for all things health and a fascination with the mysterious activity that is sleep. Outside of writing about sleep, she is a bestselling author, improviser, and creative writing teacher based out of Austin.

Combination Sleeper

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