Obstructive sleep apnoea and obesity

Abstract

The global obesity epidemic continues to gain momentum, and South Africa is one of those countries with an extremely high prevalence of obesity. The reported association between obstructive sleep apnoea (OSA) and obesity has resulted in a parallel increase in the incidence of OSA. Obesity and OSA interact by inducing systemic inflammation, metabolic aberrations and endocrine abnormalities, all of which predispose patients to atherosclerosis and cardiovascular disease. OSA is associated with a pro-inflammatory state, and increased serum C-reactive protein concentrations. Cardiovascular complications of OSA include myocardial infarction, stroke, congestive heart failure, hypertension and cardiac arrhythmias. The complications of OSA and obesity result in reduced quality of life, significant morbidity, and increased mortality, for untreated patients. OSA causes symptoms such as snoring, apnoea, excessive daytime sleepiness, and morning headaches, but 80-90% of patients are never diagnosed, or treated for their condition. Recognition of these symptoms, and referral of patients for a polysomnogram (home-or laboratory-based), expedites the diagnosis and therapy of OSA. While continuous positive airway pressure (CPAP) remains the mainstay of therapy, dietary measures are important, and should be implemented. Loss of weight can lead to significant reductions in the apnoea-hypopnoea index (AHI) of patients with OSA, and obese patients with OSA should aim for a 10% reduction in body weight.

Prevalence of Obstructive Sleep Apnea Among Obese Individuals in Ahmedabad - An Observational Study

“…These include excessive daytime sleepiness, fatigue, morning headaches, memory impairment, an increased tendency to be involved in motor vehicle accidents, personality changes and depression. [4] Obesity is the most powerful risk factor for obstructive sleep apnea OSA. [5] Obesity occurs over time with the consumption of too many calories or too little expenditure of calories through activity or exercise or both overconsumption and underexpenditure.…”

“…This loss of muscle tone leads to a collapse of the upper airway during sleep, especially if a predisposing factor such as obesity is present. [4] STOP-BANG questionnaire is a concise, effective, and reliable OSA screening tool which has a sensitivity of 92.9% and 100%, for detecting moderate and severe OSA, respectively.…”

The evaluation of adenotonsillectomy on TNF-α and IL-6 levels in obese children with obstructive sleep apnea

“…Furthermore, few studies have reported on cytokine changes pre-and post-T&A in obese children. Because TNF-a and IL-6 levels are influenced by OSA and obesity [13,18], to better evaluate the effect of T&A therapy on obese children with OSA and the follow-up risks of EDS, we collected clinical data of AHI, nadir SaO 2 and BMI and determined TNF-a and IL-6 plasma levels before T&A and 6 months after the surgical treatment. Subsequently, we investigated the correlation of TNF-a and IL-6 levels with AHI and BMI measurements and analyzed the likely explanation for the changes pre-and posttreatment.…”

The Effect of Change in Posture on Spirometry in Patients with Obstructive Sleep Apnoea Syndrome

“…OSAS is mainly related to obesity, which is defined as a body mass index (BMI) of more than 30 kg/m 2 4. As the prevalence of obesity has increased, there has been a parallel increase in the prevalence of OSAS 5…”