sleep apnea obesity

the coexistence of osa and obesity may have more widespread implications for cardiovascular control and dysfunction in obese individuals and may contribute to some of the clustering of abnormalities broadly defined as the metabolic syndrome. several reports have shown that the prevalence of hypertension is greater in patients with osa and vice versa. in addition to established daytime hypertension, osa also causes acute nocturnal surges in blood pressure in response to chemoreflex-mediated hypoxic stimulation of sympathetic activity, with a resultant increase in peripheral vascular resistance.14 these nocturnal increases in blood pressure may reach levels as high as 240/120 mm hg and are readily reversed by cpap (figure 3).14 it is possible that osa, at least in part, contributes to the nocturnal “nondipping” pattern of hypertension, which may be associated with an adverse cardiovascular prognosis.15download figuredownload powerpointfigure 3. superimposed recordings of the electrooculogram (eog), electroencephalogram (eeg), electromyogram (emg), ecg (ekg), sympathetic nerve activity (sna), respiration (resp), and blood pressure (bp) during rem sleep in a patient with osa. several cross-sectional studies have consistently found an association between increased body weight and the risk of osa.16 significant sleep apnea is present in ≈40% of obese individuals,17 and ≈70% of osa patients are obese. it may be related to changes in patients’ lifestyle, so that subjects with osa may be predisposed to weight gain because of daytime somnolence and a decrease in physical activity.

first, there is a possibility of the confounding influence of osa in studies of obesity in humans. specifically, obesity is associated with sodium retention and volume expansion, as a result of impaired pressure natriuresis and increased tubular reabsorption.39,40 the precise mechanisms of these abnormalities are unclear but may be related to the activation of the sympathetic nervous system and the renin-angiotensin system. thus, the activation of the renin-angiotensin-aldosterone system in obesity may be augmented by the presence of osa and may contribute to obesity/osa-related hypertension. several studies have found that baroreflex gain may be reduced in obese humans.28,71 interestingly, the reduced baroreflex gain appears to be related to a higher level of abdominal visceral fat.72 patients with osa have blunted heart rate variability and increased blood pressure variability,73 both of which are associated with baroreflex dysfunction. menopause is also associated with an increase in central obesity and the metabolic syndrome80 and may also be a risk factor for sleep-disordered breathing, independent of body habitus.81,82 the potential interaction of osa with the development of central obesity in postmenopausal women might contribute to the postmenopausal increase in hypertension and cardiovascular disease. the stigmata of syndrome x should therefore be broadened to incorporate osa, perhaps a “syndrome z.”84 by contributing to and/or inducing some of the above abnormalities, coexisting osa may have implications for understanding first, cardiovascular and metabolic control in obesity; second, the risk of hypertension in obese individuals; and third, the potentiating effects of osa in eliciting cardiovascular consequences in the obese patients with hypertension.

while people of all shapes and sizes can be diagnosed with obstructive sleep apnea (osa), obesity seems to be an underlying risk factor. we’ve taken a look at the research to find the connection between sleep apnea and obesity. studies have demonstrated that obesity increases the risks of developing osa and that losing weight may help reduce the risk of developing sleep apnea. “there is evidence that treating obesity reduces the severity of obstructive sleep apnea and that treating obstructive sleep apnea decreases obesity, ” a 2009 study published in clinics in chest medicine concluded.1 osa is often treated with a continuous positive airway pressure (cpap) therapy, which is considered the “gold standard” of sleep apnea treatment. given how intertwined obesity and sleep apnea are, truly effective treatment may require a broader approach.

“weight loss has been accompanied by improvement in characteristics related not only to obesity but to osa as well, suggesting that weight loss might be a cornerstone of the treatment of both conditions.”3 weight loss can be difficult to achieve if you’re also suffering from other symptoms of sleep apnea (like constant sleepiness and lack of energy). “osa is a complex condition, and treatment cannot be limited to any single symptom or feature of the disease,” the 2010 chest study notes. basically, weight loss can help alleviate conditions associated with both sleep apnea and obesity. clinical evidence shows that, taken together, sleep apnea and obesity can leave people at a greater risk for fatal health events. a 1991 study published in the journal of internal medicine found that “morbidly obese men with a history of osas [obstructive sleep apnea syndrome] have a high risk of sudden cardiovascular death, despite the absence of other conventional risk factors.”4 this blog post contains general information about medical conditions and potential treatments.

in adults, the most common cause of obstructive sleep apnea is excess weight and obesity, which is associated with the soft tissue of the among the risk factors for osa, obesity is probably the most important. several cross-sectional studies have consistently found an association between increased but being overweight is still a high risk factor for the development of obstructive sleep apnea. on one hand, carrying the extra weight can lead to, .

there is a linear correlation between obesity and osa. in obese people, fat deposits in the upper respiratory tract narrow the airway; there is a decrease in muscle activity in this region, leading to hypoxic and apneic episodes, ultimately resulting in sleep apnea. excess body weight contributes to sleep apnea by causing increased pressure on upper airways, leading to collapse and decreased neuromuscular control from the fatty deposits. these fatty deposits contribute to decreased lung volume and make it more difficult to breathe (young, skatrud & peppard, 2013). obesity has long been recognised as the most important reversible risk factor for obstructive sleep apnoea (osa). analyses from the wisconsin sleep cohort osa and weight gain appear to have a somewhat cyclical relationship. studies have demonstrated that obesity increases the risks of developing osa and that, .

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