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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors suggest the hypothesis that the obesity often associated with sleep apnea syndromes is related to changes in HG secretion. Indeed, as HG secretion is sleep related any disturbances due to apnea during may alter the GH secretion. In order to test their hypothesis the authors studied, during the course of 24-hour polygraphic recordings, the levels of HG, blood glucose and free fatty acids, in 16 subjects, 14 of whom were obese and 9 of whom had the sleep apnea syndrome. The results obtained confirmed the relationship between the number of apnea and the stability of sleep. They also demonstrated a relationship between GH secretion and both the stability of sleep and obesity. These results, therefore, suggest that apnea plays a role in obesity development.
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PMID:[Nycterohemeral variations in plasma growth hormone (GH) levels and sleep apnea syndromes: their relationship with obesity (author's transl)]. 730 33

Although flow-volume curves are valuable in detecting extrathoracic airway obstruction, their role in testing patients with sleep-disordered breathing is undefined. To determine whether patients with sleep-disordered breathing have abnormal flow-volume curves consistent with variable extrathoracic obstruction, 60 subjects referred with suspected sleep disorders prospectively underwent spirometry and assessment of flow-volume curves. These tests were interpreted independent of the outcome of polysomnography. Fourteen of 35 subjects (40%) with sleep-disordered breathing had abnormal flow-volume curves consistent with variable extrathoracic airway obstruction, and 2 of 25 (8%) with no breathing disorder had extrathoracic obstruction (p less than 0.02). The presence of extrathoracic airway obstruction in subjects with mixed or obstructive sleep apnea did not correlate with age, the presence of snoring, excessive daytime hypersomnolence, obesity, or the severity of sleep apnea. Abnormal flow-volume curves were found more frequently in women who had no obvious structural upper airway abnormality. Because of the high specificity (92%) of the flow-volume curve, the finding of extrathoracic obstruction in patients with a history consistent with sleep-disordered breathing substantially increases the likelihood that sleep apnea is present.
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PMID:Abnormal inspiratory flow-volume curves in patients with sleep-disordered breathing. 730 12

We performed polysomnography and measured hypoxic ventilatory (HVR), hypercapnic ventilatory responses (HCVR) in 42 patients (60 +/- 11 years) with obesity and a clinical suspicion of sleep apnea syndrome (SAS) in order to determine whether an altered chemosensitivity was associated with SAS. The apnea/hypopnea index was 38 +/- 20 events per hour of sleep in 28 patients (SAS+ group) and less than 10 in the 14 others (SAS- group). The 2 groups differed only by a lower waking PaO2 in SAS+ as compared to SAS- (71.0 +/- 9 vs 77.4 +/- 8 mmHg, p < 0.05). HVR and HCVR were not significantly different in the 2 groups (0.82 +/- 0.58 vs 0.86 +/- 0.37 l.min-1.%-1; 1.41 +/- 0.81 vs 1.40 +/- 0.67 l.min-1.mmHg-1, respectively). In SAS+ group, HVR or HCVR did not change 3 or 12 months after continuous positive airway pressure (CPAP) therapy while both polysomnography and PaO2 returned to normal. We conclude that in patients with mild obesity and SAS there is no difference in chemosensitivity due to the presence of sleep apnea and that CPAP therapy does not alter these measurements. These results suggest no direct effect of SAS on chemosensitivity in the population studied.
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PMID:[Study of chemosensitivity in patients believed to have sleep apnea syndrome]. 748 Oct 48

The indications and limitations of simple veloamygdalotomy as surgical cure for sleep apnoea were analyzed on the basis of results obtained in the first 150 cases treated prospectively by pharyngotomy. Clinical and polysomnographic results were analyzed as possible factors predicting success or failure. With a success rate of 80%, pharyngotomy is a simple and effective treatment for patients with minor forms of sleep apnoea (initial apnoea/hypopnoea index < 20) and no severe obesity. It appears unreasonable to propose isolated pharyngotomy if the initial index is < 30 since the success rate in the cases is only 27%. Nasal repermeation does not improve overall results significantly. The lack of patient compliance to diagnostic and therapeutic modalities is an unavoidable reality due to human, social and economic implications.
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PMID:[Analysis of results of pharyngotomy in the surgical treatment of sleep apnea syndrome. Apropos of 150 cases]. 748 15

Four boys aged 6-16 years with neurodevelopmental deficits were treated with CPAP for obstructive sleep apnoea. Their diagnoses were: Obesity with mild mental retardation, (2) attention deficit hyperactivity disorder, (3) epilepsy associated with left hemiparesis and (4) mild mental retardation due to fragile X syndrome. Previous therapeutic attempts, including adenotonsillectomy, amitriptyline and methylphenidate in our patients prior to CPAP treatment were unsuccessful. A follow-up period of 12-48 months demonstrated a number of clinical benefits such as improvement in sleep quality and daily arousal, and a decrease in the frequency of seizures and episodes of pneumonia. Polysomnographic studies indicated a significant improvement in sleep parameters such as apnoea frequency, awakenings, sleep efficiency and arterial oxygen saturation. Side effects were mild and readily alleviated. CPAP is a feasible therapeutic intervention in intractable obstructive sleep apnoea of childhood, even when associated with neurodevelopmental deficits.
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PMID:CPAP treatment of obstructive sleep apnoea and neurodevelopmental deficits. 754 99

Several new developments promise to improve the lot of the morbidly obese. Perhaps the most important of these is the gradual recognition that morbid obesity is a serious illness that is not the result of immorality or gluttony but is, in most cases, a disabling genetically determined handicap. The second advance was the agreement at the National Institutes of Health Consensus Conference, March 25-27, 1991 that medical therapies generally fail to control severe obesity and that surgery should be considered for those individuals who have a body mass index over 40 and, if the comorbidities of obesity, such as diabetes or sleep apnea, are present, to consider surgical intervention when the body mass index is greater than 35. The third development has been the improvement of bariatric surgery, ie, the surgery for morbid obesity, with better operations, better quality controls, and rigorous follow-up. This article reviews the newer concepts of morbid obesity as a disease, delineates the indications for surgery, describes the currently recommended operations, and presents the risks and benefits of these procedures.
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PMID:The surgical treatment of morbid obesity. 758 66

Post-poliomyelitis respiratory impairment is extremely common and entails considerable risk of morbidity and mortality. Respiratory muscle weakness is the primary etiological factor but post-poliomyelitis individuals (PPIs) also have a high incidence of scoliosis, obesity, sleep disordered breathing, and bulbar muscle dysfunction, all of which can add to the risk. One hundred forty-five PPIs were managed by noninvasive alternatives to intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy. When properly managed in this manner, acute respiratory failure requiring hospitalization, tracheal intubation, and bronchoscopies were avoided. Timely introduction of mouthpiece IPPV, nasal IPPV, manually and mechanically assisted coughing, and noninvasive blood gas monitoring in the home were the principal techniques used for optimizing quality of life and for avoiding complications.
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PMID:Management of post-polio respiratory sequelae. 761 64

Much has been written about snoring and its affects on health, in particular its possible influence on cardiovascular disease. However, there are many assumptions made when linking the report of snoring to any consequences such as hypertension, heart disease or stroke. In particular it is not clear how snoring might influence the cardiovascular system, whether subjective reports of snoring are accurate, and snoring might only be acting as a marker for some common risk factor such as upper body obesity; a particular risk factor for cardiovascular disease, and through neck circumference, snoring. There is much better evidence that snoring is an important cause of sleepiness, even in the absence of conventional sleep apnoea.
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PMID:Epidemiology of snoring and its consequences. 761 44

We have identified 17 obese patients (body mass index, BMI, 37.9 +/- 4.1) with proteinuria > 1 g/day (1.3-6.4 g/24 h, mean 3.1 +/- 1.7). Their age was 34-70 years (48.3 +/- 10); 11 were females and 6 males. Six patients had only one functioning kidney and a sleep apnea syndrome had been diagnosed in 5. Renal biopsies, obtained in 5 cases, showed focal glomerulosclerosis in 2 cases, minimal changes in 2 and mesangial proliferation in 1. Nine patients (group 1) were treated with hypocaloric diets; body weight significantly decreased (BMI 37.1 +/- 3, 34 +/- 3.5 and 32.6 +/- 3.2 at 0, 6 and 12 months, respectively) as well as proteinuria (2.9 +/- 1.7, 1.2 +/- 1 and 0.4 +/- 0.6 g/24 h). There was a significant correlation between body weight loss and decrease in proteinuria (r = 0.69, p < 0.05). Eight patients (group 2) were treated with captopril, without dietary changes. BMI remained stable but proteinuria showed a dramatic decrease, similar to that in group 1 (3.4 +/- 1.7, 1.2 +/- 0.9 and 0.7 +/- 1 g/24 h, respectively). Renal function remained stable in both groups. In summary, both body weight loss and captopril treatment can induce a sharp decrease in obesity-related proteinuria.
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PMID:Effects of body-weight loss and captopril treatment on proteinuria associated with obesity. 761 15

Numerous studies have suggested an alteration of sympathetic nervous system functioning in sleep apnea. However, most of these studies did not control for confounding factors such as diet, obesity, hypertension and anti-hypertensive medications. We examined plasma and urinary catecholamines in 43 patients, including hypertensive and normotensive individuals with and without sleep apnea. Hypertensive patients were studied at least 3 weeks following tapering of anti-hypertensive medication. All patients consumed similar diets and were of similar age and level of obesity. Twenty-four-hour urinary norepinephrine levels were significantly higher in apneics (58.2 ng vs. 40.2 ng in nonapneics, p < 0.002). Urinary norepinephrine in apneics was increased during both day and night. Plasma norepinephrine levels were not significantly elevated in apneic patients but were elevated in hypertensive patients both during sleep and in the morning (p < 0.05).
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PMID:The effect of sleep apnea on plasma and urinary catecholamines. 767 72


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