Obesity and the lung: 2 {middle dot} Obesity and sleep-disordered breathing (original) (raw)
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Obesity Hypoventilation Syndrome as a Spectrum of Respiratory Disturbances During Sleep
Chest, 2001
Objective: To identify the spectrum of respiratory disturbances during sleep in patients with obesity hypoventilation syndrome (OHS) and to examine the response of hypercapnia to treatment of the specific ventilatory sleep disturbances. Designs and methods: Twenty-three patients with chronic awake hypercapnia (mean [؎ SD] PaCO 2 , 55 ؎ 6 mm Hg) and a respiratory sleep disorder were retrospectively identified. Nocturnal polysomnography testing was performed, and flow limitation (FL) was identified from the inspiratory flow-time contour. Obstructive hypoventilation was inferred from sustained FL coupled with O 2 desaturation that was corrected with treatment of the upper airway obstruction. Central hypoventilation was inferred from sustained O 2 desaturation that persisted after the correction of the upper airway obstruction. Treatment was initiated, and follow-up awake PaCO 2 measurements were obtained (follow-up range, 4 days to 7 years).
Obstructive Sleep Apnea Syndrome and the correlation with obesity
CONNECTING EXPERTISE MULTIDISCIPLINARY DEVELOPMENT FOR THE FUTURE
Introduction: Sleep apnea is a chronic, disabling disorder that has alarming consequences, since its pathophysiological mechanism implies changes in respiratory control. It consists of partial or total obstruction of the upper airways resulting in reduction or interruption of oxygen flow for 10 seconds, interrupting sleep. Method: Bibliographic review study in the databases Scielo, Virtual Health Library (VHL) and Google Scholar published from 2008 to April 2021, in Portuguese and English being randomized clinical trials, excluding other types of studies. Results: After the selection of the articles, based on the inclusion and exclusion criteria, 16 articles were included for the elaboration of the analysis and the abstract. Obstruction of the upper airways in obese patients occurs by excess adipose tissue, which accumulates in some organs and makes the respiratory system narrower, aggravating its manifestation. The coexistence of Obstructive Sleep Apnea Syndrome with obesity exacer...
Obesity hypoventilation syndrome – The big and the breathless
Sleep Medicine Reviews, 2011
s u m m a r y Daytime hypercapnia that develops in morbidly obese individuals in the absence of concurrent lung or neuromuscular disease is referred to as the obesity hypoventilation syndrome (OHS). The characteristic polysomnographic (PSG) abnormality is marked sleep hypoxemia. Although the likelihood of hypoventilation increases with increasing body mass index (BMI), it is too simplistic to think of this disorder arising merely from chest wall restriction due to excess weight. Rather, this is a disorder which emerges when the compensatory mechanisms that normally operate to maintain ventilation appropriate for the level of obesity are impaired. OHS develops from a complex interaction between abnormal respiratory function, sleep disordered breathing and diminished respiratory drive. Irrespective of the mechanisms underlying the development of this disorder, early recognition of the problem and institution of effective therapy is important to reduce the significant clinical and societal repercussions of OHS. While therapy directed at improving sleep disordered breathing is effective in reversing daytime respiratory failure, it is not universally successful and information regarding longer term clinical outcomes is limited. Attention to weight reduction strategies are also necessary to reduce comorbid conditions and improve quality of life, but data regarding how successful and sustained this is in obesity hypoventilation are sparse.
Respiratory care, 2015
Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA) and to determine clinical predictors of OHS in obese subjects. Demographics, body mass index (BMI), Epworth Sleepiness Scale score, polysomnographic data, ABG, spirometric measurements, and serum bicarbonate levels were recorded. Of 152 obese subjects with OSA (79 females/73 males, mean age of 50.3 ± 10.6 y, BMI of 40.1 ± 5.6 kg/m(2), 51.9% with severe OSA), 42.1% (n = 64) had OHS. Subjects with OHS had higher BMI (P = .02), neck circumference (P < .001), waist circumference (P < .001), waist/hip ratio (P = .02), Epworth Sleepiness Scale scores (P = .036), ABG and serum bicarbonate levels (P < .001), apnea-hypopnea index (P = .01), oxygen desaturation index (P < .001), and total sleep ti...