“I have dealt with chronic fatigue and poor sleep for three years now, and it just seems to be getting worse,” said a member of MyObesityTeam. If you’re living with obesity, you might relate.

Sleep problems are common among people with obesity, and they can seriously affect your health, mood, and day-to-day life. In fact, poor sleep can even make it harder to manage your weight. In the United States, more than 40 percent of adults live with obesity, and over 1 in 5 have a diagnosed sleep disorder.

You’ve probably heard about the link between obesity and obstructive sleep apnea (OSA), a condition that causes repeated breathing interruptions during sleep. But what you might not know is that people living with obesity may have other sleep problems, too.

This article explores four common sleep challenges linked to obesity and how to treat them to improve both your sleep and overall health.

1. Obstructive Sleep Apnea

OSA happens when the upper airway becomes partially or fully blocked during sleep, causing repeated pauses in breathing. During these interruptions, the brain and body get less oxygen, which can lead to serious health problems over time.

OSA symptoms include:

• Loud snoring
• Gasping for air while asleep
• Daytime sleepiness
• Morning headaches
• Brain fog or trouble concentrating

People living with obesity are at a much higher risk of OSA. Excess weight around the neck can narrow the airway and increase pressure on it, especially when lying down.

In one study of 1,042 adults published in the journal Sleep Medicine, 63 percent of men with obesity had OSA, compared with 11 percent of men in the “normal” weight range. Among women, 22 percent of those with obesity had OSA, compared to 3 percent of women with weight in the normal range.

If you or a loved one is experiencing symptoms of OSA, ask your doctor if a polysomnography (sleep study) would be right for you. This test can be done in a sleep lab or at home, depending on your resources, symptoms, and preferences.

Treating Obstructive Sleep Apnea

There are many ways doctors treat OSA. Treatment often starts with lifestyle changes you can make, such as avoiding alcohol and certain medications that relax the airway. Weight loss through physical activity and healthy eating is also encouraged.

Sleeping position can make a difference. Lying on your back can make OSA symptoms worse, while sleeping on your side may help keep the airway open. To stay off your back during sleep, some doctors even suggest wearing a small backpack to bed.

For people with moderate to severe OSA, the most effective treatment is continuous positive airway pressure (CPAP) therapy. This machine gently blows air through a mask to keep the airway open while you sleep. CPAP therapy can improve breathing, reduce daytime sleepiness, and help prevent complications like hypertension (high blood pressure).

If CPAP isn’t comfortable or well tolerated, your doctor might recommend bilevel positive airway pressure (BiPAP) instead. BiPAP delivers two different levels of air pressure: higher when you breathe in, and lower when you breathe out. This can make breathing feel more natural while still supporting your airway.

Other treatment options for people who can’t use CPAP include oral appliances (worn in the mouth during sleep) and surgery. You can also ask your healthcare provider whether medications might be helpful for your OSA.

2. Insomnia

Living with obesity makes you more likely to experience insomnia — difficulty falling asleep, staying asleep, or waking up too early. There are many causes of insomnia, including imbalances in hormones (the messengers of information in the bloodstream), metabolic changes, and stress. “Daily stress is keeping me awake at night,” one MyObesityTeam member said.

Other medical conditions can also interfere with sleep. Comorbidities (when two or more conditions happen at the same time), like gastroesophageal reflux disease (GERD) or osteoarthritis, can cause nighttime pain or discomfort. One member of MyObesityTeam recently diagnosed with pseudogout (a type of arthritis) said, “I’m exhausted from not being able to sleep from the pain.”

“Daily stress is keeping me awake at night.”

— A MyObesityTeam member, on their experience with insomnia

Some studies have found that insomnia may contribute to obesity in the long term. This is because when you have trouble sleeping, your body releases hormones that can lead to weight gain. These hormone changes can make you hungrier and slow down your metabolism.

Treating Insomnia

Treating insomnia involves combining lifestyle changes, mental healthcare, and medications. Your treatment may depend on the type of insomnia you have.

Cognitive behavioral therapy (CBT) is a first-line therapy for insomnia. Many people with long-term insomnia find CBT helpful for targeting the thoughts that keep them up at night and for building routines that support better sleep. Medications to help with sleep are often used with behavior changes and therapy.

It’s important to consider good sleep hygiene when assessing why you might be experiencing insomnia. Examples of sleep hygiene recommendations include:

• Waking up and going to bed at the same time every day
• Avoiding naps, caffeine, nicotine, and alcohol
• Sleeping in a quiet, dark, cool room
• Using earplugs and/or white noise to prevent sudden noises from waking you up
• Avoiding food close to bedtime
• Getting physical activity, but at least four hours before bedtime

3. Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological (nervous-system related) condition that causes an uncontrollable urge to move the legs. This condition often gets worse at night, making it hard to fall asleep or causing you to wake up during the night. People with RLS may also have relationship challenges, as their movements can often wake up a partner.

Research shows that RLS is more common in people with obesity, possibly tied to brain chemical (dopamine) levels, genetics, or lack of iron in the blood.

Treating RLS

Doctors may consider certain medications to treat severe or long-term RLS symptoms. They may also test you for an iron deficiency, which causes similar symptoms to RLS. If you have an iron deficiency, treating it may resolve your RLS symptoms.

Research shows that restless legs syndrome is more common in people with obesity.

Some home remedies that people often use to treat RLS include:

• Soaking in warm baths before bedtime to relax the muscles
• Applying warm or cold packs to reduce sensations
• Practicing good sleep hygiene
• Exercising a few hours before bed every day
• Avoiding caffeinated drinks and other triggers like antihistamines

Many of the strategies to treat RLS are also useful for improving sleep quality, supporting weight loss, and boosting overall health.

4. Hormonal Disruptions

Obesity itself is associated with changes in levels of hormones. Disruptions of different types of hormones can have negative impacts on sleep quality. In reverse, poor quality sleep can cause increases in hormones leading to weight gain.

For example, poor sleep is associated with disruptions to leptin, the fullness hormone, and ghrelin, the hunger hormone. That’s why when you’re sleep deprived, you may find yourself craving higher-calorie snacks or not getting satisfied by small meals. Out-of-balance leptin and ghrelin can cause behaviors that contribute to weight gain, such as overeating.

Additionally, many people with obesity may be resistant to a hormone called insulin, especially if they’re also living with type 2 diabetes. When insulin isn’t working properly, blood sugar spikes throughout the night, leading to restless sleep. Furthermore, poor-quality sleep can cause insulin resistance, leading to a vicious cycle.

Treating Hormonal Imbalances

Hormone imbalances linked to obesity can affect sleep — and poor sleep can, in turn, worsen those imbalances. Taking certain steps may help interrupt this cycle. First, speak to your doctor about your sleep troubles to get evaluated for other medical causes, like diabetes or thyroid disorders. If you and your doctor believe that sleep problems are related to your body mass index (BMI), making healthy food and exercise changes can impact your sleep quality in the long term.

The Link Between Sleep and Obesity

Poor sleep can contribute to weight gain by increasing overeating behaviors and reducing the energy you have to be physically active. People with obesity are at higher risk of developing various sleep disorders, including OSA, RLS, and insomnia.

Talk to Your Doctor

If you’re stuck in a cycle of poor sleep and weight gain, you’re not alone — and support is available. Talking to your doctor about sleep issues can lead to solutions like lifestyle changes, mental health support, medications, or sleep devices.

The good news is that many habits that support better sleep, like eating balanced meals, getting regular exercise, and limiting alcohol, can also support your weight loss goals.

A healthcare provider can work with you to create a personalized plan that helps you sleep more soundly and feel like yourself again.

Join the Conversation

On MyObesityTeam, people share their experiences with obesity, get advice, and find support from others who understand.

Have you struggled with your sleep? How do you prevent restless nights? Let others know in the comments below.