Monday, 4 November 2013

#Obesity and Sleep Disorder

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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