A Study of Obesity and Sleep Disordered Breathing
Abstract
Introduction: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality and various Cardiovascular risk factors. Obesity is strongly linked with respiratory symptoms and diseases like dyspnea on exertion, obstructive sleep apnea syndrome (OSAS). This study has been undertaken to analyze the severity of hypertension in obese patients, sleep-disordered breathing (SDB) in obese patients, to analyze whether SDB is a risk factor for hypertension in obese individuals and to correlate how many obese hypertensives have correctable SDB.
Methods: A total of 200 obese patients were randomly selected from the outpatient department. Berlin's questionnaire and the Epworth sleepiness scale score (ESSS) were used to assess sleep-disordered breathing (SDB). Asian classification of obesity suggested by the World Health Organization was used for the assessment of BMI. All statistical analysis was carried out using the SPSS version20, and Appropriate Statistical tools were applied wherever required, like a test of proportion, Chi-square test etc.
Results: Out of 200 subjects, 116 were male, and 84 were female. The majority of the study population (70.0%) had suffered from obstructive sleep apnea, while the rest (30.0%) had mixed sleep apnea. The mean spread of age for total selected subjects (N=200) was 45.64±12.75 years. The body mass index (BMI) between 40 and 50 kg/m2 in 49.0% obese patient. Systemic hypertension prevailed more in male (81.0%) obese subjects than female (77.4%) obese subjects. The most significant risk factor for predicting hypertension was moderate type sleep apnea (p<0.005) followed by the age of the (p<0.007) obese patients that were confirmed strongly significant on the statistical ground.
Conclusion: Obesity has a very high and proportionate correlation between sleeping disordered breathing. Obstructive sleep apnea is the predominant sleep-disordered breathing in our study population. Sleep-disordered breathing is very much correctable in the obese hypertensive population by weight reduction and risk factor control.
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References
Lopez PP, Stefan B, Schulman CI, Byers PM. Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Am Surg. 2008 Sep;74(9):834-8.
Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000 Dec 20;284(23):3015-21. doi: 10.1001/jama.284.23.3015.
Biyonga I. Sleep and obesity A preliminary study conducted at the sleep laboratory at Montfort Hospital., schweizer archiv für neurologie und psychiatrie. 2012;163(6):214-20.
Namysłowski G, Scierski W, Mrówka-Kata K, Kawecka I, Kawecki D, Czecior E. Sleep study in patients with overweight and obesity. J Physiol Pharmacol. 2005 Dec;56 Suppl 6:59-65.
Mathai SC, Hassoun PM, Puhan MA, Zhou Y, Wise RA. Sex differences in response to tadalafil in pulmonary arterial hypertension. Chest. 2015 Jan;147(1):188-197. doi: 10.1378/chest.14-0263.
Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998 Jan;157(1):144-8. doi: 10.1164/ajrccm.157.1.9706079.
Robinson GV, Stradling JR, Davies RJ. Sleep. 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. Thorax. 2004 Dec;59(12):1089-94. doi: 10.1136/thx.2003.015875.
Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992 Feb;47(2):101-5. doi: 10.1136/thx.47.2.101.
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized parallel trial. Lancet. 2002 Jan 19;359(9302):204-10. doi: 10.1016/S0140-6736(02)07445-7.
Dean DA, Wang R, Jacobs DR, Duprez D, Punjabi NM, Zee PC, et al. A systematic assessment of the association of polysomnographic indices with blood pressure: the Multi-Ethnic Study of Atherosclerosis (MESA). Sleep. 2015 Apr 1;38(4):587-96. doi: 10.5665/sleep.4576.
Hoffstein V. Blood pressure, snoring, obesity, and nocturnal hypoxaemia. Lancet. 1994 Sep 3;344(8923):643-5. doi: 10.1016/s0140-6736(94)92084-2.
Lopez PP, Stefan B, Schulman CI, Byers PM. Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Am Surg. 2008 Sep;74(9):834-8.
Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000 Dec 20;284(23):3015-21. doi: 10.1001/jama.284.23.3015.
Biyonga i. Sleep and obesity A preliminary study conducted at the sleep laboratory at Montfort Hospital., schweizer archiv für neurologie und psychiatrie. 2012;163(6):214-20.
Namysłowski G, Scierski W, Mrówka-Kata K, Kawecka I, Kawecki D, Czecior E. Sleep study in patients with overweight and obesity. J Physiol Pharmacol. 2005 Dec;56 Suppl 6:59-65.
Mathai SC, Hassoun PM, Puhan MA, Zhou Y, Wise RA. Sex differences in response to tadalafil in pulmonary arterial hypertension. Chest. 2015 Jan;147(1):188-197. doi: 10.1378/chest.14-0263.
Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998 Jan;157(1):144-8. doi: 10.1164/ajrccm.157.1.9706079.
Robinson GV, Stradling JR, Davies RJ. Sleep . 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. Thorax. 2004 Dec;59(12):1089-94. doi: 10.1136/thx.2003.015875.
Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992 Feb;47(2):101-5. doi: 10.1136/thx.47.2.101.
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized parallel trial. Lancet. 2002 Jan 19;359(9302):204-10. doi: 10.1016/S0140-6736(02)07445-7.
Dean DA, Wang R, Jacobs DR, Duprez D, Punjabi NM, Zee PC, et al. A systematic assessment of the association of polysomnographic indices with blood pressure: the Multi-Ethnic Study of Atherosclerosis (MESA). Sleep. 2015 Apr 1;38(4):587-96. doi: 10.5665/sleep.4576.
Hoffstein V. Blood pressure, snoring, obesity, and nocturnal hypoxaemia. Lancet. 1994 Sep 3;344(8923):643-5. doi: 10.1016/s0140-6736(94)92084-2.
Grunstein RR, Stenlöf K, Hedner J, Sjöström L. Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish Obese Subjects (SOS) Study. Int J Obes Relat Metab Disord. 1995 Jun;19(6):410-8.
Lavie P. Sleep habits and sleep disturbances in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. Sleep. 1981;4(2):147-58. doi: 10.1093/sleep/4.2.147.
Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA. 2000 Apr 12;283(14):1829-36. doi: 10.1001/jama.283.14.1829.
Robinson GV, Stradling JR, Davies RJ. Sleep . 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. Thorax. 2004 Dec;59(12):1089-94. doi: 10.1136/thx.2003.015875.
Wang Q, Zhang C, Jia P, Zhang J, Feng L, Wei S, et al. The association between the phenotype of excessive daytime sleepiness and blood pressure in patients with obstructive sleep apnea-hypopnea syndrome. Int J Med Sci. 2014 May 9;11(7):713-20. doi: 10.7150/ijms.7487.
Tomas konecny and oxana babecka kucharcukova links between the financial and real sectors in soe: the case of the czech republic, cnb roe, praha 2014.
Brennan M, O'Brien E, O'Malley K. The effect of age on blood pressure and heart rate variability in hypertension. J Hypertens Suppl. 1986 Dec;4(6):S269-72.
Hoffstein V. Blood pressure, snoring, obesity, and nocturnal hypoxaemia. Lancet. 1994 Sep 3;344(8923):643-5. doi: 10.1016/s0140-6736(94)92084-2.
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