Abdominal Compression Increases Upper Airway Collapsibility During Sleep in Obese Male Obstructive Sleep Apnea Patients

Stadler, Daniel; McEvoy, R. Doug; Sprecher, KE; Thomson, Kieron; Ryan, Melissa; Thompson, C; Catcheside, Peter

doi:10.1093/sleep/32.12.1579

Cited by 69 publications

(36 citation statements)

References 56 publications

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“…This means that individuals succeeded in decreasing their abdominal fat. It has been reported that abdominal fat, BMI and NC are significant clinical predictors of OSAS [26,27]. NC has been suggested to be more predictive of OSAS than general obesity and the lack of impact on overall OSAS severity could be related to lack of significant difference in the change in NC [28].…”

Section: Discussionmentioning

confidence: 99%

Effect of Mediterranean dietversusprudent diet combined with physical activity on OSAS: a randomised trial

Papandreou¹,

Schiza²,

Bouloukaki³

et al. 2011

Eur Respir J

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We aimed to evaluate the effect of the Mediterranean diet (MD) compared with a prudent diet (PD) combined with physical activity on obese obstructive sleep apnoea syndrome (OSAS) patients who were treated with continuous positive airway pressure. 900 patients were evaluated and 40 obese patients (body mass index o30.0 kg?m -2 ) who met the inclusion criteria, with moderate-to-severe OSAS (apnoea-hypopnoea index (AHI) .15 events?h -1 and Epworth Sleepiness Scale score .10) based on overnight attended polysomnography, were included in the study. After randomisation, 20 patients followed the MD and 20 a PD for a 6-month period. All patients were counselled to increase their physical activity.Concerning sleep parameters, only AHI during rapid eye movement (REM) sleep was reduced to a statistically significant degree, by mean¡SD 18.4¡17.6 events?h Our results showed that the MD combined with physical activity for a 6-month period was effective in reducing the AHI during REM sleep without any statistically significant effect in the other sleep parameters, compared with a PD in obese adults with moderate-to-severe OSAS.

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Section: Discussionmentioning

confidence: 99%

Effect of Mediterranean dietversusprudent diet combined with physical activity on OSAS: a randomised trial

Papandreou¹,

Schiza²,

Bouloukaki³

et al. 2011

Eur Respir J

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“…However, neck circumference also reflects central fat distribution. Centrally distributed fat has detrimental effects on thoraco-pulmonary mechanics 35 and upper airway collapsibility, 36 particularly in recumbent positions, increasing the effort breathing, 35 and may favor mouth opening during sleep.…”

Section: Discussionmentioning

confidence: 99%

Nasal obstruction and male gender contribute to the persistence of mouth opening during sleep in CPAP‐treated obstructive sleep apnoea

et al. 2015

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“…A decrease in lung volume potentially reduces the degree of caudal traction exerted on the UA, and promotes UA collapse. Support for this interaction can be found in a study where abdominal compression during sleep in OSA patients worsened UA collapse [8]. The effect of abdominal obesity on UA function may be most evident in the supine posture and during sleep, particularly at the wake-sleep transition when other compensatory mechanisms become diminished.…”

Section: Airway Structural Challenges Of Osa and Momentioning

confidence: 91%

Morbid Obesity and Obstructive Sleep Apnea: The Challenging Link

Ebert¹

2011

TOATJ

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Abstract:Obstructive sleep apnea (OSA) is a common medical condition that is increasing in prevalence and is associated with substantial morbidity and a 40% eight-year mortality rate if left untreated. Morbidly obese patients have a greater incidence of co-morbid disease, including OSA. OSA is characterized by repeated upper airway obstruction and arousal during sleep, sympathetic activation, hypertension and daytime somnolence. In morbidly obese OSA patients undergoing surgical procedures, the perioperative period is more challenging than in non obese OSA patients. Their airway anatomy is often abnormal with excess pharyngeal tissue and tongue size making it difficult to ventilate thru a facemask and to establish tracheal intubation. Several suggestions for optimizing the anesthetic induction, emergence, and early recovery periods in these patients are offered. Most important are positioning of the patient (both during and post surgery), pre-oxygenation prior to intubation, proper dosing of anesthetic maintenance drugs to ideal body weight, alveolar recruitment maneuvers, full reversal of paralysis at the end of surgery, and careful drug titration in recovery to improve pulmonary mechanics. With proper preparation and precautions it is possible to avoid the significant high frequency of respiratory and cardiac complications observed in these patients and to avoid or better manage length of hospital stay, unplanned ICU admission and/or reintubation.

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Abdominal Compression Increases Upper Airway Collapsibility During Sleep in Obese Male Obstructive Sleep Apnea Patients

Abstract: Abdominal compression negatively impacts on UA collapsibility during sleep and this effect may help explain strong associations between central obesity and obstructive sleep apnea.

Cited by 69 publications

References 56 publications

Effect of Mediterranean dietversusprudent diet combined with physical activity on OSAS: a randomised trial

Effect of Mediterranean dietversusprudent diet combined with physical activity on OSAS: a randomised trial

Nasal obstruction and male gender contribute to the persistence of mouth opening during sleep in CPAP‐treated obstructive sleep apnoea

Morbid Obesity and Obstructive Sleep Apnea: The Challenging Link

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