The holiday season means one thing for most people: indulgent meals, sweet treats, and a few extra pounds by New Year's. While everyone faces the temptation of seasonal eating, if you have sleep apnea, those extra holiday pounds aren't just about how your jeans fit. Weight gain can directly impact your breathing at night and worsen your sleep apnea symptoms just when you need your energy most for family gatherings and end-of-year celebrations.
Why the Holidays Hit Sleep Apnea Patients Harder
Winter months bring a perfect storm of challenges for people managing sleep-disordered breathing. Between Thanksgiving feasts, office holiday parties, family celebrations, and New Year's toasts, the opportunities for overindulgence multiply while daylight shrinks and motivation to exercise often disappears.
For those with sleep apnea, this isn't just about vanity. Research shows that even gaining 10% of your body weight can increase the severity of OSA by up to 32%.1 That holiday weight, often dismissed as temporary, can mean more apnea events per hour, increased daytime fatigue, and greater strain on your cardiovascular system.
The Sleep-Deprived Brain Craves Comfort Food
Here's what makes resisting seasonal treats especially difficult when you have sleep apnea: your disrupted sleep is actively working against your willpower.
Hormonal Shifts: When sleep is frequently interrupted, it affects the balance of hormones that control appetite. Ghrelin, which signals hunger, tends to rise, while leptin, which signals fullness, drops. This combination can make you feel hungrier than usual, even if you’ve eaten enough. Research shows that sleep-deprived people often consume 300–500 extra calories a day, which adds up quickly during the holidays.
Low Energy and Quick Fixes: Fatigue from poor sleep can also lead to cravings for high-carb or sugary foods that offer a short burst of energy. It’s your body’s way of trying to compensate for feeling drained — not a lack of willpower.
Holiday Stress: Seasonal stress from travel, social obligations, and family gatherings can elevate cortisol, a hormone linked to increased appetite and comfort eating. When paired with disrupted sleep, it becomes even harder to make balanced choices.
How Holiday Weight Worsens Sleep Apnea
Even modest holiday weight gain can worsen sleep apnea symptoms. Extra fat around the neck and upper body narrows the airway, making it more likely to collapse during sleep and cause louder snoring, more awakenings, and lower oxygen levels.
On the flip side, weight loss has been shown to meaningfully improve sleep apnea severity. A 2021 review found that for every kilogram (about 2.2 pounds) of weight lost, the AHI improves by nearly one event per hour. Another 2024 study observed that a 20% reduction in BMI among people with obesity led to significant decreases in OSA severity and improved sleep quality.2
If you use CPAP or an oral appliance, even small weight changes can affect how well your treatment works. You might notice your snoring returns, your mask fit changes, or you feel less rested. These are signs to check in with your sleep specialist to fine-tune your therapy and stay ahead of seasonal setbacks.
6 Steps for a Holiday Health Action Plan
Managing sleep apnea during the season of comfort food requires strategy, not deprivation. Here's how to enjoy the holidays while protecting your health:
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Stick With Your CPAP Therapy!
If you use a CPAP machine, continuous positive airway pressure treatment is your secret weapon during the holidays. Consistent CPAP use helps normalize those hunger hormones we talked about earlier, making it genuinely easier to resist overeating. Studies show that regular CPAP therapy improves insulin sensitivity and glucose metabolism, both crucial for weight management.
Don't skip nights, even when you're exhausted from holiday parties or sleeping in a guest room. Pack your CPAP when traveling, so make sure to bring your travel case and be aware of international voltage.
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Prioritize Your Sleep
Late-night holiday parties and irregular schedules wreak havoc on sleep quality. Prioritize 7-9 hours of sleep nightly, even during festive weeks. Good sleep hygiene supports your CPAP effectiveness and helps regulate the hormones that control appetite and metabolism.
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Choose Your Indulgences Strategically
You don't need to skip every holiday treat, that's unrealistic and takes the joy out of the season! Instead, be selective. Ask if you really love this food, or if you’re just eating it because it's there. Practice portion control by using smaller plates, eating slowly, and stopping when you're satisfied rather than stuffed.
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Stay Active Despite the Cold
Winter weather and shortened daylight make it tempting to hibernate, but physical activity is crucial for managing both sleep apnea and weight. Exercise helps with weight management, improves sleep quality, reduces sleep apnea severity, and burns off extra holiday calories.
It doesn’t need to be intense. A 30-minute daily walk, holiday shopping on foot, or playing in the snow with kids or grandkids all count. Indoor options include mall walking, home workout videos, or joining a gym for the winter months. Try to be aware of your weight, and watch gradual weight gain before it becomes significant.
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Limit Alcohol Intake
Holiday celebrations often include alcohol, but alcohol is particularly problematic for people with sleep apnea. It relaxes the muscles in your throat and airway, increasing the likelihood of airway collapse and worsening OSA symptoms, even if you're using CPAP therapy. Alcohol also adds empty calories that contribute to weight gain and disrupts sleep quality. If you choose to drink, do so in moderation and avoid alcohol within 3-4 hours of bedtime when possible.
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Stay Hydrated and Eat Protein
Dehydration can mimic hunger, leading to unnecessary snacking. Drink water throughout the day, especially before meals and holiday parties. Starting meals with protein-rich foods helps you feel fuller longer and can reduce cravings for sugary comfort foods later.
The Gift of Good Health
The holidays are about celebration, connection, and joy, not perfection. You may gain a pound or two, and that's okay. The goal isn't to emerge from the holiday season unchanged, but to navigate it mindfully with your sleep apnea management as a priority.
By sticking with your CPAP therapy, making conscious food choices, staying active, and prioritizing sleep, you can enjoy the comfort foods and festivities without compromising your respiratory health. Remember, every healthy choice you make supports better sleep, and better sleep makes every aspect of the holiday season more enjoyable.
If you've noticed your sleep apnea symptoms worsening or you're struggling to manage weight gain, reach out to your sleep specialist or healthcare provider. They can adjust your treatment plan and provide personalized guidance for maintaining your health through the winter months and beyond.
SOURCES
https://pmc.ncbi.nlm.nih.gov/articles/PMC7874406/?utm_source
