Obstructive sleep apnea and obesity: implications for public health

Abstract

Obstructive sleep apnea (OSA) is a global disease with a rising incidence along with its comorbidities, especially with metabolic syndrome. One of the main components contributing to sleep apnea is obesity; as well as diabetes mellitus type 2 (T2DM), hypercholesterolemia, and hypertension. OSA is a condition that requires management and the disease can be treated by using CPAP therapy. The awareness of this global issue is rising, and health care systems are providing preventive measures, diagnosis and the treatment options. The major preventable risk factors to decrease obesity are the awareness of lifestyle modification (eating behaviors, smoking, drinking alcohol, etc.) and understanding the importance of exercise. If these lifestyle modifications are widely applied, then not only will the consequences of obesity and sleep apnea be reduced, but also the incidence of cardiovascular disease will decrease greatly. Public awareness of the importance of weight loss by lifestyle modification or bariatric surgery to improve the quality of life is needed. These preventive actions, screening measures, and treatment strategies for obesity and OSA can significantly reduce the incidence of obesity, as well as OSA and the related comorbidities such as cardiovascular disease, atherosclerosis, and depression. Finally, health care costs will also be reduced.

Impact of Obstructive Sleep Apnea On In-Hospital Outcomes in Patients With Atrial Fibrillation: A Retrospective Analysis of the National Inpatient Sample

“…Obesity, type 2 diabetes mellitus, hypercholesterolemia, and hypertension are well-studied risk factors of both AF and sleep apnea [29]. As expected, in our study population, nearly 50% of patients in the OSA group were obese compared to 14% in the non-OSA group.…”

Poor sleep and the metabolic derangements associated with obesity in adult males

“…These breathing disorders of sleep might be the reason for fragmented sleep, decreased sleep efficiency, daytime fatigue and sleepiness, and increased sleep latencies in obese. [ 3 ]…”

“…All these factors culminate in the development of obesity,[ 2 ] and obesity leads to disturbed sleep due to complete or partial obstruction of upper airways because of fat deposition. [ 3 ] Thus, a vicious cycle is established between obesity and poor sleep. Although the causal association of short sleep and obesity has been well established in various epidemiological and experimental studies, sleep assessment is still a neglected aspect of management in obese people.…”

Associação de esteatose hepática em pacientes em pré-operatório de cirurgia bariátrica com apneia obstrutiva do sono

“…A apneia obstrutiva do sono (AOS) é uma doença global com uma incidência crescente que se associa à síndrome metabólica, especialmente à obesidade (Jehan et al, 2017;Gami et al, 2003;Li et al 2018). É um distúrbio que consiste na obstrução das vias aéreas superiores, hipóxia crônica intermitente e fragmentação do sono (Young et al, 1993).…”

“…A hipóxia tecidual causada pela hipoxemia, é o principal fator contribuinte para a aterosclerose, é reconhecida como principal fator de risco para doenças cardiovasculares. Com o tratamento adequado da obesidade obtém-se melhora no IMC, bem como nos índices e na gravidade da AOS, na redução do colapso das vias aéreas superiores e também de problemas cardiovasculares associados (Jehan et al, 2017;Shah & Roux, 2009). A relação entre obesidade e AOS, também é reversa, podendo a obesidade também ser consequência da AOS.…”