Obstructive sleep apnea (OSA) and Obesity

 

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into a light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.

 OSA(obstructive sleep apnea) adversely affects multiple organs and systems and may be especially relevant to cardiovascular disease. It has been implicated in the etiology (cause) of hypertension and in the progression of several established medical conditions such as congestive heart failure, atrial fibrillation, diabetes, and pulmonary hypertension.

   In the adult population, the prevalence of OSA is estimated to be ~25%, and as high as 45% in obese people. Obesity predisposes to and potentiates OSA. The prevalence of OSA and its consequences are likely to increase in light of the current obesity epidemic. Recent estimates suggest that 60% of the adult population in industrialized countries is overweight (BMI ≥ 25 kg/m2), and at least 30% is obese (BMI ≥ 30 kg/m2). Sleep fragmentation is an important consequence of OSA. Sleep deprivation has been linked to metabolic dysregulation independent of obesity and OSA, suggesting important interactions between these conditions and increasing the complexity of their treatment.

Weight loss provides benefits not only on OSA severity but also regarding mitigating cardio metabolic (diabetes, high blood pressure), consequences related to both OSA and obesity. Unfortunately, weight loss through diet, exercise, and/or medications has been hard to achieve and are high to maintain, you need to find a provider that understand that problem and is willing to help you also, CPAP therapy will contribute to the weight loss process and will improve some of the metabolic abnormalities characteristic of OSA and obesity. However, it is clear that treatment of OSA cannot be limited to any single strategy, but rather requires a multidisciplinary approach, effective provider-patient communications, and systematic long-term follow-up to achieve an effective and long-lasting therapeutic success.

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