Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The contribution of body fat distribution to sleep-disordered breathing in women has not been examined in detail (to our knowledge). Fifty women under 65 years of age were diagnosed as having obstructive sleep apnea (OSA) by all-night polysomnography in a 6-month period. Twenty-five women underwent body fat measurements of skin folds and circumferences. The 12 premenopausal and 13 postmenopausal women did not differ in regard to apnea hypopnea index (AHI), SaO2 nadir, body mass index (BMI), or anthropometric measurements. The AHI for these 25 patients was related to the severity of obesity assessed by triceps and subscapular skin folds, the sum of the skin folds, waist circumference, and BMI. The SaO2 nadir correlated with triceps and subscapular skin folds, the sum of the skin folds, and neck skin fold. Clinical features of this same group of 25 women were then compared with those of 45 men with OSA previously described by our laboratory. The women, despite similar age, had less severe OSA than the men (AHI of 34.4 +/- 5.4 vs 51.1 +/- 4.9, p < 0.05). Despite similar BMIs and waist circumference, the men had evidence of a greater degree of upper body obesity with a larger subscapular skin fold thickness, waist-hip ratio, and neck circumference. In addition, for a given degree of upper-body obesity, men had more severe sleep apnea. These findings may explain, at least in part, the greater severity of OSA in the men.
 ...
PMID:Body fat distribution and sleep apnea severity in women. 784 62

This article provides an in-depth overview of the relationship between primary hypertension and adult obstructive sleep apnea syndrome. The background data and research are taken from the English-language literature through 1993. Primary hypertension is a common cause of major medical illnesses, including stroke, heart disease, and renal failure, in middle-aged males. Its prevalence in the United States is around 20%, with the rate of newly diagnosed hypertensive patients being about 3% per year. Sleep apnea syndrome is common in the same population. It is estimated that up to 2% of women and 4% of men in the working population meet criteria for sleep apnea syndrome. The prevalence may be much higher in older, non-working men. Many of the factors predisposing to hypertension in middle age, such as obesity and the male sex, are also associated with sleep apnea. Recent publications describe a 30% prevalence of occult sleep apnea among middle-aged males with so called "primary hypertension." Is this association fortuitous, related to a high prevalence of both diseases in the same population, or is it caused by a factor common to both diseases, such as obesity? Should the diagnosis of apnea be actively sought with sleep studies in hypertensive populations? If a diagnosis of "asymptomatic" sleep apnea is made in a hypertensive person, should the apnea be treated? Current research data provide only partial answers to these and other questions regarding the association of apnea and hypertension. Logic dictates that clinically symptomatic patients in hypertensive clinics should receive appropriate evaluation for apnea, but broad populations of hypertensive individuals should not be referred for sleep studies.
 ...
PMID:The relationship between systemic hypertension and obstructive sleep apnea: facts and theory. 784 28

We report a patient with severe obstructive sleep apnea (OSA) associated with a unique combination of syringobulbia-myelia, Chiari malformation type I (CM), absent hypoxic ventilatory drive, vocal cord paralysis, post-menopausal status, obesity, and acute respiratory failure necessitating mechanical ventilation. The remote onset of OSA five years after surgery underscores the need for long-term follow-up of patients with syringobulbia-myelia and CM and the importance of addressing multiple interacting neurologic, metabolic, and mechanical predispositions to sleep-disordered breathing.
 ...
PMID:Multifactorial obstructive sleep apnea in a patient with Chiari malformation. 785 32

Obstructive sleep apnea (OSA) is a common disorder in which upper-airway obstruction during sleep results in cessation of breathing. OSA is associated with increased morbidity and mortality and impaired daytime functioning. Upper-body obesity is a risk factor for OSA, and it is well documented that weight loss has a notable ameliorative impact on the occurrence of OSA. Nasal continuous positive airway pressure (nCPAP) during sleep is the primary treatment for OSA, and is usually effective in relieving upper-airway obstruction. However, compliance with prolonged nCPAP use has been proven problematic. Upper-airway surgeries may be efficacious for the treatment of OSA in carefully selected patients, but often are not successful for obese patients with OSA. The concomitant use of nCPAP and behavioral weight loss therapy in obese patients with OSA may result in enhanced weight loss. In moderately obese patients, modest weight reduction may alleviate the need for long-term nCPAP therapy or upper-airway surgery. Severely obese patients usually require more substantial weight loss and may be candidates for behavioral therapy in combination with gastric surgery. The role of the dietitian in the treatment of OSA cannot be overemphasized and warrants further development and study.
 ...
PMID:Weight loss for obstructive sleep apnea: the optimal therapy for obese patients. 796 74

Fifty unselected consecutive patients with obstructive sleep apnea syndrome (OSAS) diagnosed by nocturnal recordings of respiration movements by a static charge sensitive bed (SCSB) and oximetry, alone or combined with polysomnography, were studied. Renewed SCSB-oximetry recordings evaluated treatment. Six months after surgery, 30 of 50 were classified as responders. Twenty-one months after surgery, 19 of 49 were responders. Patients who relapsed showed a significant increase in mean body mass index (BMI). Four years after surgery, 24 of 48 patients were responders. Preoperative BMI was significantly lower in the responder group. Subsequent treatment was required in 15 nonresponders. There was no correlation between patients' subjective improvement and objective results. The study resulted in the following conclusions: 1. The responder rate to UPPP in unselected patients is low. 2. Obesity and high indices of nocturnal respiratory disturbance are negative predictors. 3. The patients' subjective recovery alone must not be used for postoperative evaluation. 4. With regular follow-up and the use of the treatment alternatives available today, the majority of OSAS patients can receive effective treatment.
 ...
PMID:Four-year follow-up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. 796 65

Obstructive sleep apnea syndrome (OSAS) is a major health problem, not only because of its consequences in terms of morbidity and mortality, but also because of its social impact in the form of car accidents and industrial accidents. These facts stress the necessity of screening OSAS among the population, particularly in patients suffering from obesity or hypertension, diseases frequently associated with OSAS. This review will focus on the epidemiology and the pathophysiology of this syndrome, its clinical features with a view to screening OSAS, and the main examination used to confirm the diagnosis. The management of OSAS will be discussed.
 ...
PMID:Obstructive sleep apnea syndrome: a frequent complication of obesity. 799 78

This review provides a historical background on sleep-related eating disorders, summarizes findings from a series of 38 adults, and presents a current classification. The "night-eating syndrome" was first reported in 1955; only nine reports on this syndrome appeared during the next 36 years, seven being single-case studies and two containing the objective monitoring of sleep, that is, polysomnography. In 1991 our sleep center reported on 19 cases, and in 1993 on 38 cases, diagnosed by polysomnography and clinical evaluations. Mean age was 39 years, mean duration of night-eating was 12 years, 66% were women, 68% had nightly binge eating, and 44% were overweight from night-eating. Sleepwalking was the predominant disorder responsible for night-eating; restless legs syndrome, obstructive sleep apnea, and various other conditions (including two cases of anorexia nervosa) were also identified. Cognitive-behavioral therapies were ineffective, but pharmacotherapy was very effective in controlling night-eating and inducing loss of excess weight, and often consisted of a dopaminergic agent taken with codeine at bedtime. Thus, sleep-related eating can be an occult but often treatable cause of obesity. Further research, utilizing polysomnography, is encouraged.
 ...
PMID:Review of nocturnal sleep-related eating disorders. 803 49

Sleep-related eating disorders distinct from daytime eating disorders have recently been shown to be associated with sleepwalking (SW), periodic limb movement (PLM) disorder and triazolam abuse in a series of 19 adults. We now report eight other primary or combined etiologies identified by clinical evaluations and polysomnographic monitoring of 19 additional adults (mean age 40 years; 58% female): i) obstructive sleep apnea (OSA), with eating during apnea-induced confusional arousals (n = 3); ii) OSA-PLM disorder (n = 1); iii) familial SW and sleep-related eating (n = 2); iv) SW-PLM disorder (n = 1); v) SW-irregular sleep/wake pattern disorder (n = 1); vi) familial restless legs syndrome and sleep-related eating (n = 2); vii) anorexia nervosa with nocturnal bulimia (n = 2) and viii) amitriptyline treatment of migraines (n = 1). In our cumulative series of 38 patients (excluding six with simple obesity from daytime overeating), 44% were overweight (i.e. > 20% excess weight) from sleep-related eating. Nightly sleep-related binge eating (without hunger or purging) had occurred in 84% of patients. Onset of sleep-related eating was also closely linked with i) acute stress involving reality-based concerns about the safety of family members or about relationship problems (n = 6), ii) abstinence from alcohol and opiate/cocaine abuse (n = 2) and iii) cessation of cigarette smoking (n = 2). Current treatment data indicate a primary role of dopaminergic agents (carbidopa/L-dopa; bromocriptine), often combined with codeine and clonazepam, in controlling most cases involving SW and/or PLM disorder. Fluoxetine was effective in two of three patients. Nasal continuous positive airway pressure therapy controlled sleep-related eating in two OSA patients.
 ...
PMID:Additional categories of sleep-related eating disorders and the current status of treatment. 810 56

1. Obstructive sleep apnoea and snoring are associated with daytime hypertension. It is uncertain whether this association is directly due to the disturbed sleeping respiration or the result of confounding variables, particularly obesity, smoking and alcohol intake. 2. Ambulatory blood pressure and echocardiographic left ventricular muscle mass were measured in 19 patients with obstructive sleep apnoea, 19 men who snore without apnoea and 38 control subjects matched for age, sex, body mass index, smoking and alcohol intake. Ambulatory blood pressure was also measured before and after treatment in 11 patients with obstructive sleep apnoea and their matched control subjects. 3. Compared with matched control subjects, untreated obstructive sleep apnoea and snoring were not associated with an increase in daytime blood pressure. A daytime elevation of either systolic or diastolic blood pressure of > 3.8 mmHg due to obstructive sleep apnoea or snoring was excluded with 95% confidence in each of the study groups. Daytime blood pressure was also unchanged when obstructive sleep apnoea was treated with nasal continuous positive airway pressure. Night-time blood pressure was not significantly different in the patients with obstructive sleep apnoea or the snorers when compared with their matched control subjects. However, a fall in night-time systolic blood pressure was seen in the patients with obstructive sleep apnoea after treatment [fall in systolic blood pressure -6.3 (SD 8.2) mmHg, P < 0.02]. 4. Left ventricular diameter, wall thickness and calculated mass were similar in each of the study groups and their matched control groups.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Ambulatory blood pressure and left ventricular hypertrophy in subjects with untreated obstructive sleep apnoea and snoring, compared with matched control subjects, and their response to treatment. 816 36

Obstructive sleep apnoea (OSA) has been estimated to affect between 1 and 4% of the total population. OSA may be more frequent among women than studies based on subjects presenting for treatment would indicate. The aim of this study was to determine the prevalence of OSA in an obese female population (BMI > 30 kg/m2, age > 18 years) who presented to a hospital-based obesity clinic. The women were screened by an overnight ambulatory sleep study (MESAM) to detect OSA. Subjective sleep quality and sleep disturbance were assessed by a 19-item questionnaire, the Pittsburg sleep quality index (PSQI). From a population of 108 women, 29 were screened by MESAM. OSA was determined on the basis of respiratory disturbance index (RDI). The prevalence of OSA, defined as five or more respiratory disturbances per hour, was 37.9%. The mean age of the women was 43.6 +/- 2.57 years (mean +/- s.e.m.) and they had a mean BMI of 40.7 +/- 1.40 kg/m2. There was a significant positive correlation for RDI and BMI (r = 0.71; P < 0.001). Our findings indicate that over one third of women had OSA, yet they did not complain of symptoms even though the PSQI questionnaire indicated that they were poor sleepers. Non-specific symptomatology of OSA may be important diagnostically, particularly in women, and obese women should be considered at risk of OSA.
 ...
PMID:The prevalence of obstructive sleep apnoea in an obese female population. 818 15


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>