Approach the Patient With Obstructive Sleep Apnea and Obesity

Abstract

Obstructive sleep apnoea (OSA) and obesity are highly prevalent and bidirectionally associated. OSA is however underrecognized, particularly in women. By mechanisms that overlap with those of obesity, OSA increases the risk of developing, or having poor outcomes from, comorbid chronic disorders and impairs quality of life. Using two illustrative cases we discuss the relationships between OSA and obesity with type 2 diabetes, dyslipidemia, cardiovascular disease, cognitive disturbance, mood disorders, lower urinary tract symptoms, sexual function, and reproductive disorders. The differences in OSA between men and women, the phenotypic variability of OSA, and co-morbid sleep disorders are highlighted. When the probability of OSA is high due to consistent symptoms, comorbidities, or both, a diagnostic sleep study is advisable. Continuous positive airway pressure or mandibular advancement splints improve symptoms. Benefits for comorbidities are variable depending on nightly duration of use. By contrast weight loss and optimization of lifestyle behaviors are consistently beneficial.

Effect of Obstructive Sleep Apnea during Pregnancy on Fetal Development: Gene Expression Profile of Cord Blood

“…Moreover, the environmental context adds another layer of complexity. Lifestyle factors such as smoking, obesity, and sedentary behavior exacerbate the severity of OSA, further complicating its management and outcomes [40][41][42]. Comprehending the complex interplay among genetic predisposition, intermittent hypoxia, and environmental factors is essential to fully understand the spectrum of OSA and craft personalized therapeutic interventions.…”

Exploring the Complex Interplay of Obesity, Allergic Diseases, and Sleep-Disordered Breathing In Children

“…Paediatric obesity is a significant risk factor for OSA, mainly due to anatomical and inflammatory reasons. Fat deposition in these areas can increase airway resistance and impair respiratory dynamics [15,16]. Obese children also exhibit anomalies during sleep, such as positive pharyngeal pressure and less pharyngeal dilatory activity [17].…”