Effects of treatment by laser-assisted uvuloplasty on sleep energy expenditure in obstructive sleep apnea patients

Relationship between severity of nocturnal desaturation and adaptive thermogenesis: preliminary data of apneic patients tested in a whole-body indirect calorimetry chamber

“…When we repeated the same statistical procedure with SMR as the dependent variable and body weight and age as the predicting variables (r 2 ¼ 0.69, Po0.0001), we found no significant difference between measured and predicted values in the apneic group (Table 1). This result is also in contrast with the findings of Lin et al, 20 who observed an increased level of EE during sleep and a subsequent fall of this level in those who responded successfully to a treatment by laser-assisted uvulopalatoplasty. In their protocol, Lin et al 20 measured overnight EE by using a ventilated hood to collect expiratory gases.…”

“…This result is also in contrast with the findings of Lin et al, 20 who observed an increased level of EE during sleep and a subsequent fall of this level in those who responded successfully to a treatment by laser-assisted uvulopalatoplasty. In their protocol, Lin et al 20 measured overnight EE by using a ventilated hood to collect expiratory gases. Stenlof et al 19 had also demonstrated results similar to those of Lin et al They observed a greater overnight EE in their apneic patients than in those displaying a less severe form of OSAS.…”

Impact of Treatment with Continuous Positive Airway Pressure (CPAP) on Weight in Obstructive Sleep Apnea

“…Some but not all studies indicate that resting 24-hour as well as sleep EE in persons with OSA are higher than in those without OSA. 17,18 Furthermore, EE may be higher in those with greater severity of OSA. 19 Elevated EE during sleep in OSA patients may be related to greater work of breathing, similar to that observed in patients with chronic obstructive lung disease.…”

“…22 Intervention with CPAP as well as upper airway surgery has been shown to reduce sleep EE, and in the absence of change in energy intake would favor weight gain. 17,18,23 Alterations in level of physical activity and dietary habits with CPAP also could change the balance between EI and EE in OSA. Although patients with OSA often indicate that sleepiness and lack of energy are barriers to increased physical activity, a recent study observed that intervention with CPAP for three months improved sleepiness but did not alter activity levels.…”

Clinical significance of adaptive thermogenesis

“…84 The relationship between OSAS and propensity to weight gain and obesity 85,86 seems therefore paradoxical based on the fact that this disease is also characterized by several energy consuming factors such as sleep deprivation, sleep fragmentation, increase in breathing effort and motor activity, [87][88][89] as well as with activation of sympathetic activity 90,91 and increased EE. 92,93 In order to better investigate this issue, eight obese individuals with positive diagnosis for OSAS (determined by continuous nocturnal home oxymetry) were tested in the whole-body indirect calorimetric chamber in Laval University. 60 EE was measured as described previously 94 and the severity of OSAS was evaluated by the percentage of total recording time spent below 90% arterial oxygen saturation (% TRT o90% SaO 2 ).…”