Obesity and Obstructive Sleep Apnoea

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13 Dec Obesity and Obstructive Sleep Apnoea

Posted at 16:31h in Blog by admin

There is a direct relationship between obesity and obstructive sleep apnoea (OSA)[1]. Studies have demonstrated that change in weight is directly proportional to breathing disorders during sleep and that the severity of the apnoea increases with weight. OSA is caused by inadequate airflow in the upper airways due to complete or partial airway collapse. In obese people, excess fat in the upper airway narrows the airway and decreases muscle activity, leading to episodes of lack of airflow during sleep and ultimately OSA[1]. The lack of airflow causes decreased oxygen in the blood and body tissue which is the main contributor to risk factors for Cardiovascular Diseases[2]. The poor sleep caused by OSA has implications spanning multiple areas of health due to the wide range of symptoms, one of these being an increased chance of obesity.

 

People who constantly have less than 6 hours sleep can develop hormonal imbalances such as altered levels of melatonin, ghrelin and leptin that can predispose to obesity due to the associated increased food intake[3][4][5]. OSA can develop if adequate sleep duration, quality and healthy weight is not maintained. OSA can then exacerbate the factors contributing to obesity, such as poor sleep, increased appetite and lowered daytime energy levels[6].

 

It has been shown that weight reduction can reduce sleep problems and have a positive effect on sleep quality and duration[7]. Weight loss is the key factor in the treatment of OSA. Exercise helps in decreasing weight, blood pressure, depression, anxiety and fatigue and combined with diet changes and/or medication can reduce obesity and severity of OSA[1][8]. The conventional treatment for OSA is CPAP. CPAP delivers constant airflow to the airway during sleep and significantly relieves OSA symptoms and improves daytime function, including reduction in lowered energy levels that contribute to sedentary lifestyles and in turn obesity. Bariatric surgery is another option, and has shown to offer great improvement in OSA[9]. It is considered for patients where weight loss through diet, exercise and CPAP therapy has failed.

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  4. Chaput JP, Després JP, Bouchard C, Tremblay A. Short sleep duration is associated with reduced leptin levels and increased adiposity: results from the Quebec family study. Obesity (Silver Spring) 2007;15(1):253–261
  5. Horne J. Short sleep is a questionable risk factor for obesity and related disorders: statistical versus clinical significance. Biol Psychol. 2008;77(3):266–276
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  7. Steinberg DM, Christy J, Batch BC, Askew S, Moore RH. Preventing Weight Gain Improves Sleep Quality Among Black Women: Results from a RCT. Ann Behav Med. 2017;51(4):555–566
  8. Jehan S, Auguste E, Zizi F, Pandi-Perumal SR, Gupta R, et al. Obstructive Sleep Apnea: Women’s Perspective. J Sleep Med Disord. 2016;3(6)
  9. Fritscher LG, Canani S, Mottin CC, Fritscher CC, Berleze D, et al. Bariatric surgery in the treatment of obstructive sleep apnea in morbidly obese patients. Respiration. 2007;74(6):647–652