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

Sleep disordered breathing has increasingly been recognised as a frequent cause of ill-health in the community. Moderate or severe forms of the most common condition, obstructive sleep apnea (OSA), occur in up to 12% of the adult male population. A substantial body of literature has been published on the potential relationship between OSA and cardiovascular disease. In particular, OSA has been associated with cardiac failure, stroke, myocardial infarction and hypertension. Part of this association may be explained by other confounders, mainly obesity, which is common in OSA patients. The present review was prepared following a workshop aimed to critically review available scientific evidence suggesting that hypertension is a direct consequence of OSA. In addition, pathophysiologic mechanisms that may be involved in the relationship between OSA and cardiovascular disease, particularly brief intermittent elevation of blood pressure and sustained systemic hypertension, are discussed.
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PMID:Obstructive sleep apnea and blood pressure elevation: what is the relationship? Working Group on OSA and Hypertension. 820 10

Our study included 42 patients with obstructive sleep apnea (OSAS) confirmed by polysomnography. In these patients we investigated the clinical manifestations, the results of the laboratory examinations, including polysomnography, ORL observations and tests of pulmonary function, as well as the therapeutic results. Our patients presented a serious set of symptoms which included excessive daytime sleepiness, snoring, obesity, cranio-facial abnormalities, systemic hypertension, cardiac arrhythmias, incapacity to work with precocious retirement, marital conflicts and high incidence of accidents, namely traffic accidents. An adequate treatment, mostly with nasal CPAP (continuous positive airway pressure), induced marked relief of the symptoms; some patients had an advantage in surgical treatment and weight reduction. OSAS is a frequent entity, affecting mostly male adults after the 5th decade. The lack of knowledge about this entity and the common social acceptance of some of its cardinal symptoms induces considerable delays in its diagnosis. The severity of the symptoms, the personal and social risks of excessive daytime sleepiness, the cardio-circulatory effects and the risk of sudden death during sleep justify an early diagnosis in order to prevent the severe evolution of the disease. Its complex physiopathology and multiple etiological factors justify a multidisciplinary approach.
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PMID:[Obstructive sleep apneas. A clinical and laboratory study]. 828 15

The detection, correction or withdrawal of any cause or associated factor including obesity, drugs or alcohol is essential in the treatment of obstructive sleep apnea syndrome. Treatment is mainly mechanical or surgical, but not medical. Nasal continuous positive airway pressure (NCPAP) has now largely replaced tracheostomy and successful long-term domestic use of this method has been reported on many occasions. Oropharyngeal surgery can solve a large part of social snoring problems. However criteria for procedure selection and evaluation of results are still needed to clarify the indication of this operation in patients with full clinical expression of the syndrome. In this regard, a comprehensive preoperative evaluation and a logical approach to the reconstruction of the upper-airway has recently led to the association of palatopharyngoplasty and maxillo-mandibular surgery, with an excellent long-term success rate.
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PMID:[Treatment of obstructive sleep apnea syndromes]. 831 24

Although anatomic lesions and obesity can produce obstructive sleep apnea (OSA), most subjects with OSA have no recognizable anatomic lesion. We hypothesized that the occurrence of OSA is related to the size of the region enclosed by the mandible and the degree of obesity. We studied 30 subjects with a range of OSA and obesity with magnetic resonance imaging (MRI). MRI was performed with T-1 weighted sequences. Nocturnal polysomnography was performed in all subjects. Univariate regression analysis indicated there was a significant correlation between the number of apneas and hypopneas per hour of sleep (AH/h) and (1) the area enclosed by the mandible ramus (AMR1) (r = 0.48, p < 0.01) and (2) the distance from the teeth to the posterior mandible ramus (r = 0.39, p < 0.05). Stepwise multiple regression analysis indicated that weight, AMR1, and height explained 69% of the variance of AH/h (r2 = 0.69). We conclude that the occurrence of OSA in these subjects is related to the size of the region enclosed by the mandible as well as to their weight.
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PMID:Mandible enclosure of upper airway and weight in obstructive sleep apnea. 831 98

A patient with obesity resulting from sleep-related eating disorder demonstrated signs and symptoms of obstructive sleep apnea (OSA). Incarceration restricted access to food during the night, leading to weight loss and clinical improvement. Release from prison allowed recurrence of unrestricted sleep-eating, recurrent obesity, and documented OSA. Successful treatment of sleep-related eating disorder can result in improvement in coexisting OSA.
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PMID:Sleep-related eating disorder as a cause of obstructive sleep apnea. 833 65

The Rubinstein-Taybi syndrome is characterized by a pattern of malformations including broad thumbs and big toes, microcephaly, facial dysmorphism, small stature, and mental retardation. Obstructive sleep apnea (OSA), has been described in several facial or skeletal malformations, but never in the Rubinstein-Taybi syndrome. We studied a 9-year-old boy, previously diagnosed as having the Rubinstein-Taybi syndrome and affected by severe OSA, as documented by polysomnography. He manifested the habitual and heavy snoring with breathing difficulties at night, and excessive daytime sleepiness. Short neck and obesity were important factors for the severity of the syndrome. Continuous positive airway pressure was not tolerated and weight loss was the only possible treatment, as upper airway surgery was not indicated by cephalometric, otolaryngologic or clinical results.
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PMID:Obstructive sleep apnea in the Rubinstein-Taybi syndrome. 834 55

Although most patients with obstructive sleep apnea (OSA) are obese, it is not known how obesity contributes to airway collapse during sleep. The purpose of this study was to determine whether the volume of adipose tissue adjacent to the pharyngeal airway in humans is related to the degree of OSA. We studied 30 subjects, nine without OSA and 21 with OSA; two subjects were studied before and after weight loss. Adipose tissue was detected with magnetic resonance imaging using T1-weighted spin echo sequences. The volume of adipose tissue adjacent to the upper airway was determined by measuring the volume of all pixels in the intensity range of adipose tissue within the region bounded by the ramus of the mandible, the spine, the anterior border of the soft palate, and the hard palate. Polysomnography was performed with conventional techniques. All subjects had a collection of adipose tissue adjacent to the upper airway; the volume of this adipose tissue correlated with the number of apneas plus hypopneas per hour of sleep (r = 0.59, p < 0.001). Both patients who lost weight and had fewer apneas and hypopneas had a marked decrease in the pharyngeal adipose tissue volume. We conclude that adipose tissue is deposited adjacent to the pharyngeal airway in patients with OSA and that the volume of this tissue is related to the presence and degree of OSA.
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PMID:Pharyngeal fat in obstructive sleep apnea. 834 12

There has been no epidemiological study of snoring in Japan, and we therefore performed a questionnaire survey (in about 7,000 adult men working at a steel-making factory at the time of the yearly health examination, and investigated the relationship between the severity of snoring and 17 items including age, obesity, family history of snoring, daytime hypersomnolence, hypertension, smoking, alcohol intake and traffic accidents. We classified all the subjects into three groups, no snoring, mild snoring, and severe snoring group. We defined severe snorers as persons who snored loudly in both inspiratory and expiratory phases and those who snored loudly with apnea. We found that aging, obesity, smoking and alcohol intake are risk factors for snoring. Compared with non-snorers, severe snorers were found to have a high incidence of family history of snoring, daytime hypersomnolence, and history of treatment of hypertension. No relationship was found between the severity of snoring and the occurrence of automobile accidents. The proportion of severe snorers over 40 years old with obesity, daytime hypersomnolence and morning headache was 0.25%, representing the group that may have obstructive sleep apnea syndrome. The probable incidence of sleep apnea syndrome in men may be considerably lower in Japan compared with that in either U.S.A. or Europe.
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PMID:[Epidemiological study of snoring--a questionnaire survey in factory workers]. 834 1

We hypothesized that obese children with a history of breathing difficulty during sleep would demonstrate (1) evidence of complete and partial obstructive sleep apnea (OSA) with hypercarbia and/or hypoxemia; and (2) correlation between symptoms, degree of obesity, adenoid and tonsil size, and polysomnography (PSG) results. We evaluated 32 obese children [% ideal body weight (IBW), 196 +/- 45%] with a sleep history questionnaire, airway radiographs, electrocardiograms (ECG), and PSG. By history, we found snoring (100%), difficulty breathing (59%), sweating (44%), restlessness (53%), arousals (41%), apnea (50%), worsening with upper respiratory infection (URI) (81%), hypersomnolence (59%), and mouth breathing (59%). We found adenoid and/or tonsil enlargement on 75% of airway x-ray pictures. ECGs were abnormal in 5 patients. Among all patients, mean sleep study oxyhemoglobin saturation (SaO2) was 85 +/- 16% and mean end-tidal CO2 (PetCO2) was 51 +/- 7 torr; 84% had paradoxical inward movement of the chest on inspiration, 59% had OSA, and 66% had partial OSA. In those with > or = 200% IBW and adenotonsillar enlargement, elevated PetCO2 and the presence of hypoxemia (SaO2 < 90%) for > or = 5% of the total sleep time (TST) were correlated, unlike in patients of similar weight but without adenotonsillar enlargement. Individuals symptoms did not correlate with the severity of PSG abnormalities. By discriminant analysis, using three variables (IBW, presence of adenotonsillar tissue, and presence of > or = 5 symptoms), we could predict PSG abnormalities with up to 81% reliability. Our findings indicate that in obese children, particularly those with %IBW > or = 200 and adenotonsillar hypertrophy, with sleep-disordered breathing evaluation by polysomnography should be considered.
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PMID:Polysomnography in obese children with a history of sleep-associated breathing disorders. 836 18

Obstructive sleep apnoea (OSA) is characterized by abnormal breathing during sleep, and occurs when the upper airway is obstructed but respiratory effort continues. Causes of OSA include obesity, overindulgence in alcohol, and the use of sedatives. The patient complains of unrefreshed sleep, morning headaches and drowsiness, sometimes leading to depression and intellectual impairment. The treatment of choice is weight loss; however, the patient may also require mechanical nocturnal support to prevent the upper airway collapsing and causing OSA. A simple and effective non-surgical treatment for OSA is nasal continuous positive airway pressure.
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PMID:Management of obstructive sleep apnoea. 837 59


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