A. Obesity is defined as a medical condition of excess
body fat has accumulated overtime, while overweight is a condition of
excess body weight relatively to the height. According to the Body
Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight,
while a BMI of over 30 is an indication of obesity. According to the
statistic, 68% of American population are either overweight or obese.
B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)
C. Sleep disorder
(somnipathy) is a medical disorder of the sleep patterns. It’s
important to understand why sleep disorder can deteriorate your health
and interfere with normal physical, mental and emotional functioning as
it effects your nervous system in the production of the natural
hormone melatonin which is necessary for sleep and wakefulness.
Polysomnography testing can help to evaluate and detect the patterns of
sleep disorder.
D. How Obesity associates with Sleep Disorder
1. In the study of "Sleep apnea: a proinflammatory disorder that coaggregates with obesity" by Mehra R, Redline S., posted in PubMed, researchers found that this article elucidates mechanistic associations among obesity, sleep
apnea, and systemic inflammation; highlights interrelationships
between these factors with cardiopulmonary disease; and identifies
specific areas for future research directions.
2. According to the abstract of the study of "Postoperative considerations for patients with obesity and sleep apnea" by Bell RL, Rosenbaum SH., posted in PubMed, researchers stated that p apnea and obesity
are prevalent and often coexisting conditions that challenge medical,
anesthetic, and surgical treatment. It is essential to possess
knowledge of the magnitude of the sleep disorder
as well as concomitant medical comorbidities. Management of obese
patients requires a thorough preoperative evaluation and appraisal of
anesthetic and operative risks. Postoperatively, these patients can
present an additional challenge.
3. In a study of "Obstructive sleep apnea in the adult obese patient: implications for airway management" by Benumof JL., posted in PubMed, researchers found that Obstructive sleep
apnea in the adult obese patient may be due, in part, to an increased
amount of pharyngeal tissue. Therefore, there is an increased risk of
intubation and extubation difficulties and pain management can be
expected to be complicated by opioid/sedative-induced pharyngeal
collapse.
4. In the abstract of the study of "The relationship between obesity and craniofacial structure in obstructive sleep apnea" by Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA., posted in PubMed,
researchers that there is a spectrum of upper airway soft-tissue and
craniofacial abnormalities among OSA patients: obese patients with
increased upper airway soft-tissue structures, nonobese patients with
abnormal craniofacial structure, and an intermediate group of patients
with abnormalities in both craniofacial structure and upper airway
soft-tissue structures.
5. According to the study of "Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea" by Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S., posted in PubMed, researchers indicated that Japanese obstructive sleep
apnoea patients have a series of cephalometric abnormalities similar
to those described in Caucasian patients, and that the aetiology of
obstructive sleep apnoea in obese patients may be different from that in non-obese patients. In obese patients, upper airway soft tissue enlargement may play a more important role in the development of obstructive sleep apnoea, whereas in non-obese patients, bony structure discrepancies may be the dominant contributing factors for obstructive sleep apnoea.
6. In a study of "Dentofacial characteristics as indicator of obstructive sleep apnoea-hypopnoea syndrome in patients with severe obesity" by Maciel Santos ME, Laureano Filho JR, Campos JM, Ferraz EM., posted in PubMed,
researchers found that the most prevalent modified Mallampati index
score was between 3 and 4, while grade 1 was the most prevalent
tonsillar hypertrophy index score (46%). Cephalometry revealed angular
and linear measurements with normally acceptable values for the hard
tissues. Obese patients seem to have a normal craniofacial structure
and the risk of developing OSAHS is especially related to obesity.
7. Etc.
E. Treatments of Obesity and Sleep Disorder
1. According to the study of "Quantification of sleep behavior and of its impact on the cross-talk between the brain and peripheral metabolism" by Hanlon EC, Van Cauter E., posted in PubMed, researchers indicated that... Simultaneously, average sleep
times have progressively decreased. Recently, evidence from both
laboratory and epidemiologic studies has suggested that insufficient sleep may stimulate overeating and thus play a role in the current epidemic of obesity and diabetes,.... The findings provide evidence that sleep
restriction does indeed impair glucose metabolism and alters the
cross-talk between the periphery and the brain, favoring excessive food
intake. A better understanding of the adverse effects of sleep restriction on the CNS control of hunger and appetite may have important implications for public health.
2. In a study of "Sleep apnea and obesity" by Yu JC, Berger P 3rd., posted in PubMed, researchers wrote that Perhaps, the strongest observational evidence to support a link between sleep apnea and obesity is the similarity in age distribution of symptomatic sleep apnea and metabolic syndrome. The putative causal links between sleep
apnea and each individual component of the metabolic syndrome have
been extensively evaluated and have implicated bidirectional causality
in certain metabolic conditions, such as obesity and sleep apnea, sleep apnea and diabetes mellitus, and obesity
and diabetes mellitus. These studies collectively suggest that even
modest weight loss improves OSA, and positively affects both metabolic
and cardiovascular risk profiles.
3. in the abstract of the study of "Pharmacological treatment of obstructive sleep apnea", by Abad VC, Guilleminault C., posted in PubMed, researchers wrote that Obstructive sleep apnea (OSA) is a growing public health hazard fueled by the obesity epidemic and an aging population. Untreated sleep
apnea can result in significant consequences both in the short-term
and long-term. We need to educate the public to recognize the symptoms
of sleep apnea and to publicize that effective treatments are available. Positive airway pressure therapy remains the gold standard currently in treating OSA. Alternative treatments include an oral appliance or surgical options. This paper discusses the pharmacologic treatment of sleep
apnea: goals include medications to address the ventilatory control of
breathing, treat co-morbid diseases, treat associated health
problems/complaints, address special issues, such as anesthetic
precautions, and propose future targets.
4. Etc.
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