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AN APPROACH TO DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE SLEEP APNEA IN THE OBESE
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Abstract
Background: Obstructive sleep apnea is a common respiratory disorder related to sleep, often coexisting with cardiovascular and metabolic diseases. Obese adults have a 45% incidence of obstructive sleep apnea, which can have negative effects on the cardiovascular system and potentially result in premature death. Content: Obstructive sleep apnea is characterized by apnea or hypopnea with decreased oxygen saturation or decreased arousal during sleep, leading to sleep fragmentation and increased proinflammatory factors. The diagnostic criteria is the apneahypopnea index (AHI) ≥ 5/hour when measured by type 1 polysomnography. Obesity is a condition of excessive increase in fat mass due to nutritional and metabolic disorders, determined by a body mass index ≥ 25 kg/m2. Obesity aggravates obstructive sleep apnea by influencing upper airway collapse through mechanical or neuromuscular mechanisms. On the contrary, obstructive sleep apnea also promotes obesity due to reduced physical activity and energy metabolism. Screening for obstructive sleep apnea in obese people can be conducted through questionnaires such as Epworth, Berlin, and STOP-BANG, or simpler polygraph techniques such as type 3 or type 4. Measuring and monitoring the carbon dioxide levels in exhaled breath is also considered in the approach to diagnosing obstructive sleep apnea in obese people. Treatment of obstructive sleep apnea in obese people includes postural treatment, losing weight through lifestyle changes, medication, surgery, and continuous positive airway pressure (CPAP). Conclusions: Obesity and obstructive sleep apnea are two disorders that interact. Obese individuals' screening results and polysomnography type 3 or type 4 can be used to diagnose OSA. A variety of approaches should be used to treat OSA in obese patients, including changes in sleeping posture, weight loss, and the addition of continuous positive pressure ventilation.
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Keywords
Obstructive sleep apnea, obesity, metabolic disorder
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