The interaction of obesity and craniofacial deformity in obstructive sleep apnea

2020 ◽  
pp. 20200425
Author(s):  
Liping Huang ◽  
Xuemei Gao
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Tissues ◽  
Normal Weight ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Weight Group ◽  
Normal Weight Group ◽  
Obstructive Sleep

Objective: Both obesity and craniofacial deformity are important etiologies of obstructive sleep apnea (OSA). The present research aimed to explore their interaction and different impacts on OSA severity. Methods: A total of 207 consecutive OSA patients (169 males, 38 females) were included in the research. Based on the body mass index (BMI) value, patients were divided into 77 normal-weight patients (BMI <24 kg m−2), 105 overweight patients (24 ≤ BMI<28 kg m−2) and 26 obese patients (BMI ≥28 kg m−2). All accepted overnight polysomnography and standard lateral cephalogram. Cephalometric measurements involved 25 cephalometric variables. The correlations between these cephalometric variables, BMI and the apnea-hypopnea index (AHI) were evaluated. Results: For the whole sample after controlling for gender and age, stepwise regression analysis showed that the factors affecting AHI were increased BMI, narrowing posterior airway space, inferior displacement of hyoid and elongation of the tongue. When grouped by BMI, normal-weight group exhibited with more reduced maxillary length and mandible length, and steeper mandible plane than overweight and obese patients (p < 0.0167). Obese group showed least skeletal restriction and most prominent soft tissues enlargement (p < 0.0167). However, these skeletal indexes were not statistically correlated with AHI. Conclusions: Obesity and skeletal malformations were both etiological factors of OSA, but obesity seemed to have a greater influence on AHI severity in all kinds of obese and thin OSA patients. Only in normal-weight group, it was affected by both cephalometric variables and BMI.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Cardiac arrhythmias and conduction disturbances in the obstructive sleep apnea syndrome

2018 ◽  
Vol 2 (47) ◽  
pp. 10-15
Author(s):  
Danuta Łoboda ◽  
Karolina Simionescu ◽  
Anna Szajerska-Kurasiewicz ◽  
Dorota Lasyk ◽  
Grzegorz Jarosiński ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiac Arrhythmias ◽  
Sleep Apnea Syndrome ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Premature Ventricular Contractions ◽  
Mortality And Morbidity ◽  
Conduction Disturbances ◽  
Obstructive Sleep

Cardiac arrhythmias during sleep are reported in almost half of the population suffering from obstructive sleep apnea (OSA). The most common are bradyarrhythmias and atrial fibrillation whereas premature ventricular contractions and nonsustained ventricular tachycardia are less frequent. The risk of arrhythmia is proportional to the body mass index (BMI), number of respiratory events per hour of sleep described with apnea/hypopnea index (AHI) and the level of oxygen desaturation during these episodes. Continuous positive airway pressure (CPAP) treatment in OSA reduces the incidence of cardiac arrhythmias therefore reduce mortality and morbidity from cardiovascular disease.

scholarly journals Obstructive sleep apnea and lipid abnormalities

2017 ◽  
Vol 5 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Dimitar Karkinski ◽  
Oliver Georgievski ◽  
Pavlina Dzekova-Vidimliski ◽  
Tatajana Milenkovic ◽  
Dejan Dokic
Keyword(s):  
Obstructive Sleep Apnea ◽  
Lipid Metabolism ◽  
Sleep Apnea ◽  
Total Cholesterol ◽  
Density Lipoprotein ◽  
The Body ◽  
Lipoprotein Cholesterol ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Lipid Abnormalities

BACKGROUND: There has been a great interest in the interaction between obstructive sleep apnea (OSA) and metabolic dysfunction, but there is no consistent data suggesting that OSA is a risk factor for dyslipidemia.AIM: The aim of this cross-sectional study was to evaluate the prevalence of lipid abnormalities in patients suspected of OSA, referred to our sleep laboratory for polysomnography.MATERIAL AND METHODS: Two hundred patients referred to our hospital with suspected OSA, and all of them underwent for standard polysomnography. All patients with respiratory disturbance index (RDI) above 15 were diagnosed with OSA. In the morning after 12 hours fasting, the blood sample was collected from all patients. Blood levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), were determined in all study patients. In the study, both OSA positive and OSA negative patients were divided according to the body mass index (BMI) in two groups. The first group with BMI ≤ 30 kg/m^2 and the second group with BMI > 30 kg/m^2.RESULTS: OSA positive patients with BMI ≤ 30 kg/m^2 had statistically significant higher levels of triglycerides and total cholesterol, and statistically significant lower level of HDL compared to OSA negative patients with BMI ≤ 30. There were no statistically significant differences in age and LDL levels between these groups. OSA positive patients with BMI > 30 kg/m^2 had higher levels of triglycerides, total cholesterol and LDL and lower levels of HDL versus OSA negative patients with BMI > 30 kg/m^2, but without statistically significant differences.CONCLUSION:OSA and obesity are potent risk factors for dyslipidemias. OSA could play a significant role in worsening of lipid metabolism in non-obese patients. But in obese patients, the extra weight makes the metabolic changes of lipid metabolism, and the role of OSA is not that very important like in non-obese patients. 

Obstructive sleep apnea in normal weight patients: characteristics and comparison with overweight and obese patients

2019 ◽  
Author(s):  
Sonia Castro Quintas ◽  
Amaia Urrutia Gajate ◽  
Leyre Serrano Fernández ◽  
Marta García Moyano ◽  
Beatriz González Quero ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Normal Weight ◽  
Obese Patients ◽  
Obstructive Sleep

scholarly journals Interlink between Obesity Hypoventilation Syndrome and Obstructive Sleep Apnea. Do we need to screen patients for OHS in obese OSA patients?

2020 ◽  
Vol 4 (1) ◽  
pp. 17-20
Author(s):  
S.S. Dhakal ◽  
R. Maskey ◽  
M. Bhattarai
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Research Centre ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obesity Hypoventilation Syndrome ◽  
Arterial Blood ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Introduction: Around 90% of patients with OHS have coexistent obstructive sleep apnea (OSA) defined by an apnea–hypopnea index (AHI) >5 events/h, with nearly 70% having severe OSA (AHI > 30 events/h). Prevalence of OHS is between 8% and 20% in obese patients referred to sleep centers for evaluation of SDB. As prevalence of OHS in OSA patients data from Nepal is not available we planned to carry out the study and to address gaps in diagnosis and management. Methodology: This is a cross sectional observational study done in OM hospital and research centre from 2018 January to 2019 June. Awake daytime Arterial blood gas ( ABG) was obtained and patients having PaCO2 more than 45 mmHg were diagnosed as obesity hypoventilation syndrome in a recently diagnosed patients with OSA. Results: 32 patients diagnosed to have OSA and whose BMI is more than 30 were included in the study. Among 32 patients 26 (81.25%) were male and 6 (18.75) were female. Among all patients who underwent level A polysomnography 3 (12.5%) had mild OSA,4(16.66%) had moderate and 17 (53.12%) had severe OSA. 8 (25%) patients had normal diagnostic polysomnography. Among these patients 3(12.5%) who had mild OSA has BMI between 30-35,16 (66.66%) patients who had BMI between 30-35, 2 had mild 3 had moderate and 11 had severe OSA. Patients with BMI more than 40,5 (28.3%) had OSA among which 21 had moderate and 4 had severe OSA. Conclusions: As OHS is often misdiagnosed even in patients with severe obesity, we strongly recommended screening in obese patients with OSA for OHS as early recognition and effective treatment are important in improving morbidity and mortality in this group of patients.

Obstructive Sleep Apnea in Normal Weight Patients: Characteristics and Comparison With Overweight and Obese Patients

2013 ◽  
Vol 49 (12) ◽  
pp. 513-517 ◽  
Author(s):  
Raquel Dacal Quintas ◽  
Manuel Tumbeiro Novoa ◽  
María Teresa Alves Pérez ◽  
Mari Luz Santalla Martínez ◽  
Adela Acuña Fernández ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Normal Weight ◽  
Obese Patients ◽  
Obstructive Sleep

Glottic and cervical tracheal narrowing in patients with obstructive sleep apnea

1989 ◽  
Vol 67 (6) ◽  
pp. 2427-2431 ◽  
Author(s):  
I. Rubinstein ◽  
T. D. Bradley ◽  
N. Zamel ◽  
V. Hoffstein
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Structural Abnormality ◽  
Pathophysiological Mechanism ◽  
Obstructive Sleep

There are several studies showing that patients with idiopathic obstructive sleep apnea (OSA) have a narrow and collapsible pharynx that may predispose them to repeated upper airway occlusions during sleep. We hypothesized that this structural abnormality may also extend to the glottic and tracheal region. Consequently, we measured pharyngeal (Aph), glottic (Agl), cervical tracheal (Atr1), midtracheal (Atr2), and distal (Atr3) tracheal areas during tidal breathing in 66 patients with OSA (16 nonobese and 50 obese) and 8 nonapneic controls. We found that Aph, Agl, and Atr1, but not Atr2 or Atr3, were significantly smaller in the OSA group than in the control group. Obese patients with OSA had the smallest upper airway area, although the nonapneic controls had the largest areas. Multiple linear regression analysis revealed that the pharyngeal area, cervical tracheal area, and body mass index were all independent determinants of the apnea-hypopnea index, accounting for 31% of the variability in apnea-hypopnea index. Aph, Agl, and Atr showed significant correlation with the body mass index. We conclude that sleep-disordered breathing is associated with diffuse upper airway narrowing and that obesity contributes to this narrowing. Furthermore, we speculate that a common pathophysiological mechanism may be responsible for this reduction in upper airway area extending from the pharynx to the proximal trachea.

Outcome of Adenotonsillectomy for Obstructive Sleep Apnea in Obese and Normal-Weight Children

2007 ◽  
Vol 137 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Ron B. Mitchell ◽  
James Kelly
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Normal Weight ◽  
Apnea Hypopnea Index ◽  
Dramatic Improvement ◽  
Obese Children ◽  
Respiratory Parameters ◽  
Obstructive Sleep ◽  
Study Participants

OBJECTIVES: 1) To evaluate the relative severity of obstructive sleep apnea (OSA) in obese and normal-weight children; 2) to compare changes in respiratory parameters after adenotonsillectomy in obese and normal-weight children. STUDY DESIGN AND SETTING: Prospective controlled trial that included children aged 3 to 18 years. All study participants underwent pre- and postoperative polysomnography. RESULTS: The study population included 33 obese children and 39 normal-weight controls. Preoperatively, the median obstructive apnea-hypopnea index (AHI) was 23.4 (range 3.7-135.1) for obese and 17.1 (range 3.9-36.5) for controls ( P < 0.001). Postoperatively, the AHI was 3.1 (range 0-33.1) for obese and 1.9 (range 0.1-7.0) for controls ( P < 0.01). Twenty-five obese children (76%) and 11 controls (28%) had persistent OSA. CONCLUSION AND SIGNIFICANCE: AHI scores are higher in obese than in normal-weight children with OSA. Both groups show a dramatic improvement in AHI after adenotonsillectomy, but persistent OSA is more common in obese children.

scholarly journals Contributing Factors of Excessive Daytime Sleepiness in Morbid Obese Patients with Obstructive Sleep Apnea

2021 ◽  
Vol 39 (4) ◽  
pp. 298-304
Author(s):  
Sangil Park ◽  
Jung-Ick Byun ◽  
Sun-Min Yoon ◽  
Seungmin Lee ◽  
Kunwoo Park ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Odds Ratio ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Morbid Obese ◽  
Insomnia Severity

Background: Obesity, obstructive sleep apnea (OSA), and excessive daytime sleepiness (EDS) are common conditions and are interrelated. Obesity is a risk factor for OSA and independently associated with EDS. We aimed to evaluate frequency of EDS in morbid obese patients with OSA and to identify contribution factor for EDS.Methods: This was a retrospective cross-sectional study in single sleep center. Consecutive patients with OSA (with apnea-hypopnea index 5/h or more) with morbid obesity (body mass index over 35 kg/m2) was enrolled. EDS were defined as Epworth Sleepiness Scale of 10 points or more. Clinical and polysomnographic variables were compared between those with and without EDS.Results: Total 110 morbid obese patients with OSA were enrolled, and 34 (31%) of them had EDS. Those with EDS had higher subjective symptom of insomnia and depression. Rapid eye movement sleep latency was shorter and minimum saturation was lower for those with EDS. Multivariate logistic regression analysis identified insomnia severity (odds ratio, 1.117) and minimum saturation (odds ratio, 0.952) as independent contribution factor for EDS.Conclusions: Result of this study suggest that 31.4% of morbid obese patients with OSA have EDS, and it can be affected by insomnia severity and desaturation during sleep.

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