Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing

Peppard, Paul E.; Young, Terry; Palta, Mari; Dempsey, Jerome A.; Skatrud, James B.

doi:10.1001/jama.284.23.3015

Cited by 1,570 publications

(981 citation statements)

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“…This is a clinically relevant issue, as it could in turn complicate the management of this disease for which weight loss happens to be an efficient therapy. 101 SMR measured -SMR predicted …”

Section: Organochlorines: Obesogen Pollutants?mentioning

confidence: 97%

Clinical significance of adaptive thermogenesis

et al. 2007

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The epidemic of obesity is developing faster than the scientific understanding of an efficient way to overcome it, as reflected by the low success rate of short-and long-term weight loss interventions. From a clinical standpoint, this suggests that the body tends to defend a set point of possible genetic origin in the context of a weight-reducing program. As described in this paper, this limited therapeutic success may depend on adaptive thermogenesis, which represents in this case the decrease in energy expenditure (EE) beyond what could be predicted from the changes in fat mass or fat-free mass under conditions of standardized physical activity in response to a decrease in energy intake. This issue has been documented in recent studies that have shown in obese individuals adhering to a weight reduction program a greater than predicted decrease in EE, which in some cases was quantitatively sufficient to overcome the prescribed energy restriction, suggesting a role for adaptive thermogenesis in unsuccessful weight loss interventions and reduced body weight maintenance. As also discussed in this paper, this 'adaptive thermogenesis' can be influenced by environmental factors, which have not been frequently considered up to now. This is potentially the case for plasma organochlorine concentration and oxygen desaturation in obstructive sleep apnea syndrome. It is concluded that health professionals should be aware that in some vulnerable individuals, adaptive thermogenesis can be multicausal, and has the capacity to compensate, at least partly, for the prescribed energy deficit, possibly going beyond any good compliance of some patients.

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Section: Organochlorines: Obesogen Pollutants?mentioning

confidence: 97%

Clinical significance of adaptive thermogenesis

et al. 2007

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“…Among these, obesity is one of the strongest sleep apnea risk factors (12)(13)(14)(15). Mild to moderate obesity has been associated with markedly increased sleep apnea prevalence (3,14,16). In a community-based cohort of middle-aged subjects, Young and colleagues (1) showed that a 1-SD increase in BMI was associated with a fourfold increased risk for prevalent sleep apnea, and we have demonstrated a sleep apnea prevalence of approximately 40% in moderately overweight men from the community who are otherwise healthy (3).…”

Section: Sleep Apnea Risk Factors: Roles Of Obesity Sex Fat Distribmentioning

confidence: 99%

“…40 kg/m 2 ), the prevalence of sleep apnea was estimated to vary between 40 and 90% (17)(18)(19)(20)(21)(22)(23)(24), and the severity of sleep apnea was generally greater than that found in leaner clinical populations (17,25,26). In addition, Peppard and colleagues have provided further evidence for a link between sleep apnea and obesity by demonstrating that a 10% change in body weight was associated with a parallel change of approximately 30% in the apnea-hypopnea index (AHI), the major index of sleep apnea severity (16).…”

Section: Sleep Apnea Risk Factors: Roles Of Obesity Sex Fat Distribmentioning

confidence: 99%

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Schwartz

Patil²,

Laffan

et al. 2008

Proceedings of the American Thoracic Society

574

395

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Obstructive sleep apnea is a common disorder whose prevalence is linked to an epidemic of obesity in Western society. Sleep apnea is due to recurrent episodes of upper airway obstruction during sleep that are caused by elevations in upper airway collapsibility during sleep. Collapsibility can be increased by underlying anatomic alterations and/or disturbances in upper airway neuromuscular control, both of which play key roles in the pathogenesis of obstructive sleep apnea. Obesity and particularly central adiposity are potent risk factors for sleep apnea. They can increase pharyngeal collapsibility through mechanical effects on pharyngeal soft tissues and lung volume, and through central nervous system-acting signaling proteins (adipokines) that may affect airway neuromuscular control. Specific molecular signaling pathways encode differences in the distribution and metabolic activity of adipose tissue. These differences can produce alterations in the mechanical and neural control of upper airway collapsibility, which determine sleep apnea susceptibility. Although weight loss reduces upper airway collapsibility during sleep, it is not known whether its effects are mediated primarily by improvement in upper airway mechanical properties or neuromuscular control. A variety of behavioral, pharmacologic, and surgical approaches to weight loss may be of benefit to patients with sleep apnea, through distinct effects on the mass and activity of regional adipose stores. Examining responses to specific weight loss strategies will provide critical insight into mechanisms linking obesity and sleep apnea, and will help to elucidate the humoral and molecular predictors of weight loss responses.

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“…3,4 In the USA, more than 80% of the estimated deaths attributable to obesity occurred among individuals with body mass index (BMI) of X30, 5 and in 2004 the prevalence of BMI of X30 was 32% among adults aged 20 years or older. 6 In Japan, the prevalence of BMI X30 in 2004 was much lower at 3% among adults aged 15 years or older.…”

Section: Introductionmentioning

confidence: 99%

Associations between weight change since 20 years of age and sleep-disordered breathing among male truck drivers

et al. 2009

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Background: Limited evidence for association of weight gain with sleep-disordered breathing (SDB) has been produced for Asian populations whose body mass index (BMI) levels are lower than in western countries. Objective: The aim of this study was to examine weight change since 20 years of age and risk of SDB among Japanese. Design: Retrospective cohort study. Subjects: This study includes a large sample of 5320 male Japanese truck drivers aged 30-69 years. Measurements: The respiratory disturbance index (RDI) was selected as an indicator of SDB, and it was estimated with a onenight sleep test using an airflow monitor, and the Epworth Sleepiness Scale (ESS) was used to estimate excessive daytime sleepiness. Results: Respiratory disturbance and sleepiness were more prevalent among men with BMI of 25.0-29.9 and X30.0 kg/m 2 than among those with BMI of 18.5-24.9; multivariable odds ratios (ORs) were 1.8(1.5-2.0), Po0.001 and 4.4(3.5-5.5), Po0.001 for RDI X10, and 1.2(0.9-1.4), P ¼ 0.18 and 1.5(1.1-2.1), P ¼ 0.02 for ESS X11, respectively. Compared with men showing BMI changes within ± 1.0, the respective multivariable ORs for those with BMI changes of 3.0-4.9 and X5.0 were 1.4(1.2-1.6), Po0.001 and 2.4(2.0-2.9), Po0.001 for RDI X10, and 1.2(0.9-1.6), P ¼ 0.22 and 2.0(1.5-2.6), Po0.001 for ESS X11. The corresponding ORs for weight gain of X10.0 kg compared with weight change less than ± 5.0 kg were 2.0(1.7-2.4), Po0.001 for RDI X10 and 1.5(1.2-2.0), P ¼ 0.002 for ESS X11. Similar trends were observed for RDI X20. Conclusion: Our results suggest that an increase in BMI of X5 kg/m 2 or weight gain of X10 kg is a risk factor for SDB and excessive daytime sleepiness among Japanese truck drivers.

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Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing

Abstract: Our data indicate that clinical and public health programs that result in even modest weight control are likely to be effective in managing SDB and reducing new occurrence of SDB.

Cited by 1,570 publications

References 61 publications

Clinical significance of adaptive thermogenesis

Clinical significance of adaptive thermogenesis

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Associations between weight change since 20 years of age and sleep-disordered breathing among male truck drivers

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