1
|
Tai JE, Phillips CL, Yee BJ, Grunstein RR. Obstructive sleep apnoea in obesity: A review. Clin Obes 2024; 14:e12651. [PMID: 38419261 DOI: 10.1111/cob.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
Obstructive sleep apnea is a common comorbidity that occurs in individuals with obesity. It classically manifests with excessive daytime sleepiness, resulting in reduced quality of life, workplace productivity, and an increased risk of motor vehicle accidents. Weight gain plays an important role in its pathogenesis through worsening upper airway collapsibility, and current treatment options are targeted towards mechanically overcoming upper airway obstruction and weight loss. Continuous positive airway pressure therapy remains the most widely prescribed treatment for obstructive sleep apnea but poor tolerance is a common barrier to effective treatment. Sustainable weight loss is an important treatment option but can be difficult to achieve without bariatric surgery. The recent advances in incretin-based pharmacotherapies represent a promising avenue not only in achieving long-term weight loss but also in treating obstructive sleep apnoea and alleviating the burden of its symptoms and comorbidities.
Collapse
Affiliation(s)
- Jian E Tai
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Craig L Phillips
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Brendon J Yee
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Ronald R Grunstein
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
2
|
Lins-Filho O, Germano-Soares AH, Aguiar JLP, de Almedia JRV, Felinto EC, Lyra MJ, Leite DB, Drager LF, Farah BQ, Pedrosa RP. Effect of 12-week high-intensity interval training on hemodynamic variables at rest and during exercise in patients with obstructive sleep apnoea. J Hypertens 2024; 42:742-745. [PMID: 38230605 DOI: 10.1097/hjh.0000000000003654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This study aimed to investigate the impact of 12 weeks of high-intensity interval training (HIIT) on hemodynamic variables at rest and during exercise in patients with obstructive sleep apnoea. Twenty-six obese adults with moderate-to-severe OSA (AHI = 42 ± 22.9 e/h) were randomly assigned to HIIT or a control group. Sleep parameters, ambulatorial, aortic, and during-exercise SBP and DBP were assessed at baseline and after 12 weeks. Generalized estimated equations assessed differences between groups over time. When compared with control group, HIIT reduced AHI (17.1 ± 6.2; e/h, P < 0.01), SBP nighttime (10.2 ± 5.0 mmHg; P = 0.034), DBP nighttime (7.9 ± 4.0 mmHg; P = 0.038), DBP aortic (5.5 ± 2.9 mmHg; P = 0.048), and SBP max (29.6 ± 11.8 mmHg; P = 0.045). In patients with OSA, 12 weeks of HIIT decreases sleep apnoea severity and blood pressure in rest and during exercise.
Collapse
Affiliation(s)
- Ozeas Lins-Filho
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Departamento de Educação Física
| | | | - José Lucas Porto Aguiar
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
| | - José Ricardo Vieira de Almedia
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
| | - Elton Carlos Felinto
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
| | | | - Danielle Batista Leite
- Departamento de ergometria, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco, Recife
| | - Luciano Ferreira Drager
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo
| | - Breno Quintella Farah
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
- Departamento de educação física, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Rodrigo Pinto Pedrosa
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
| |
Collapse
|
3
|
Kim KK, Haam JH, Kim BT, Kim EM, Park JH, Rhee SY, Jeon E, Kang E, Nam GE, Koo HY, Lim JH, Jeong JE, Kim JH, Kim JW, Park JH, Hong JH, Lee SE, Min SH, Kim SJ, Kim S, Kim YH, Lee YJ, Cho YJ, Rhie YJ, Kim YH, Kang JH, Lee CB. Evaluation and Treatment of Obesity and Its Comorbidities: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2023; 32:1-24. [PMID: 36945077 PMCID: PMC10088549 DOI: 10.7570/jomes23016] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/28/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.
Collapse
Affiliation(s)
- Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Ji-Hee Haam
- Deptartment of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bom Taeck Kim
- Department of Family Practice & Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Eonju Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, Ansan, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Hyun Lim
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea
| | - Jo-Eun Jeong
- Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Jong-Hee Kim
- Department of Physical Education, Hanyang University, Seoul, Korea
| | - Jong Won Kim
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jung Ha Park
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jun Hwa Hong
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Sang Eok Lee
- Department of Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Se Hee Min
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Jun Kim
- Department of Psychiatry, Konyang University College of Medicine, Daejeon, Korea
| | - Sunyoung Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
- Depertment of Family Medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yeon Ji Lee
- Department of Family Medicine, Inha University College of Medicine, Incheon, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Youn-hee Kim
- Mindscan Clinic, Heart Scan Health Care, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| |
Collapse
|
4
|
Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med 2022; 18:2723-2729. [PMID: 35929587 PMCID: PMC9713905 DOI: 10.5664/jcsm.10190] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES A high body mass index (BMI) is a risk factor for obstructive sleep apnea. However, to our knowledge there is no reported equation that quantifies the relationship between weight, as measured by BMI, and apnea severity, as assessed by the apnea-hypopnea index (AHI). Our objective was to find a mathematical relationship between BMI and AHI. METHODS We prospectively recruited 434 veterans from our polysomnography laboratory. Veterans already undergoing a sleep study were approached, and those who consented were enrolled. The veterans who enrolled in our study also participated in their scheduled sleep study. This study was approved by our institutional review board. RESULTS We found a simple mathematical relationship between BMI and AHI: for every 1-point drop in BMI (corresponding to 5-8 pounds, depending on a person's height), AHI decreases by 6.2%. And limiting BMI to 25-40 kg/m2 (which includes about 80% of the BMIs), then AHI drops by 7.1%. Simply put as a rule of thumb: For every 7-pounds drop in weight, expect a 7% drop in AHI. CONCLUSIONS To our knowledge, this is the first simple mathematical equation that associates the severity of weight with the severity of apnea in veterans. This equation can be a practical rule of thumb that can be implemented in clinics to predict the amount of weight a patient needs to lose to decrease their apnea, which might help motivate patients to lose weight. CITATION Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med. 2022;18(12):2723-2729.
Collapse
Affiliation(s)
- Deema Fattal
- Neurology Department, University of Iowa, Iowa City, Iowa
- Iowa City VA Medical Center, Iowa City, Iowa
| | | | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa
| |
Collapse
|
5
|
Choi BY, Kim JK, Cho JH. A Review of a Recent Meta-Analysis Study on Obstructive Sleep Apnea. JOURNAL OF RHINOLOGY 2022. [DOI: 10.18787/jr.2022.00422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This paper summarizes a recent meta-analysis of various topics in obstructive sleep apnea (OSA). In addition to cardiovascular disease and neurocognitive dysfunction, a wide variety of diseases have been associated with OSA, and associations with cancer have also been reported. Although continuous positive airway pressure is a very effective treatment, the results have shown that it does not reduce the incidence of various complications. It has been reported that uvulopalatopharyngoplasty was effective, and robotic surgery for the tongue root and hypoglossal nerve stimulation were also effective. The effectiveness of various medications to reduce daytime sleepiness has also been demonstrated. Although exercise lowered the apnea-hypopnea index, it was not related to changes in body composition, and it was also reported that exercise combined with weight control were effective. Additionally, interesting and clinically meaningful meta-analysis results were summarized and presented.
Collapse
|
6
|
Arnardottir ES, Islind AS, Óskarsdóttir M, Ólafsdóttir KA, August E, Jónasdóttir L, Hrubos-Strøm H, Saavedra JM, Grote L, Hedner J, Höskuldsson S, Ágústsson JS, Jóhannsdóttir KR, McNicholas WT, Pevernagie D, Sund R, Töyräs J, Leppänen T. The Sleep Revolution project: the concept and objectives. J Sleep Res 2022; 31:e13630. [PMID: 35770626 DOI: 10.1111/jsr.13630] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 12/18/2022]
Abstract
Obstructive sleep apnea is linked to severe health consequences such as hypertension, daytime sleepiness, and cardiovascular disease. Nearly a billion people are estimated to have obstructive sleep apnea with a substantial economic burden. However, the current diagnostic parameter of obstructive sleep apnea, the apnea-hypopnea index, correlates poorly with related comorbidities and symptoms. Obstructive sleep apnea severity is measured by counting respiratory events, while other physiologically relevant consequences are ignored. Furthermore, as the clinical methods for analysing polysomnographic signals are outdated, laborious, and expensive, most patients with obstructive sleep apnea remain undiagnosed. Therefore, more personalised diagnostic approaches are urgently needed. The Sleep Revolution, funded by the European Union's Horizon 2020 Research and Innovation Programme, aims to tackle these shortcomings by developing machine learning tools to better estimate obstructive sleep apnea severity and phenotypes. This allows for improved personalised treatment options, including increased patient participation. Also, implementing these tools will alleviate the costs and increase the availability of sleep studies by decreasing manual scoring labour. Finally, the project aims to design a digital platform that functions as a bridge between researchers, patients, and clinicians, with an electronic sleep diary, objective cognitive tests, and questionnaires in a mobile application. These ambitious goals will be achieved through extensive collaboration between 39 centres, including expertise from sleep medicine, computer science, and industry and by utilising tens of thousands of retrospectively and prospectively collected sleep recordings. With the commitment of the European Sleep Research Society and Assembly of National Sleep Societies, the Sleep Revolution has the unique possibility to create new standardised guidelines for sleep medicine.
Collapse
Affiliation(s)
- Erna S Arnardottir
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Landspitali University Hospital, Reykjavik, Iceland
| | - Anna Sigridur Islind
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Department of Computer Science, Reykjavik University, Reykjavik, Iceland
| | - María Óskarsdóttir
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Department of Computer Science, Reykjavik University, Reykjavik, Iceland
| | | | - Elias August
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Department of Engineering, Reykjavik University, Reykjavik, Iceland
| | - Lára Jónasdóttir
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jose M Saavedra
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Physical Activity, Physical Education, Sport and Health (PAPESH) Research Group, Department of Sports Science, Reykjavik University, Reykjavik, Iceland
| | - Ludger Grote
- Internal Medicine, Center for Sleep and Wake Disorders, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Jan Hedner
- Internal Medicine, Center for Sleep and Wake Disorders, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | | | | | - Kamilla Rún Jóhannsdóttir
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Walter T McNicholas
- Department of Respiratory and Sleep Medicine, St. Vincent's Hospital Group, School of Medicine, University College Dublin, Dublin, Ireland
| | - Dirk Pevernagie
- Respiratory Diseases, University Hospital Ghent, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Reijo Sund
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia.,Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Timo Leppänen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | | |
Collapse
|