Last update:
   15-Jul-2010
 

Arch Hellen Med, 27(3), May-June 2010, 539-544

ORIGINAL PAPER

The link between obesity and obstructive sleep apnea syndrome

A. KAPRANA, E. PROIMOS, T. CHIMONA, D. KIAGIADAKI, C.E. PAPADAKIS
ENT Department, General Hospital of Chania, Crete, Greece

OBJECTIVE Fat deposition in the abdominal, thoracic and neck distribution pattern has been correlated with the severity of the obstructive sleep apnea syndrome (OSAS). The aim of this study was to explore the possible link between OSAS and obesity.

METHOD From January 2006 through February 2009, 291 patients were admitted to the ENT Sleep Related Breath Disorder Clinic. All the patients were first evaluated with polysomnography and found to be suffering from mild to severe OSAS. The assessment was completed with blood tests, cephalometric measurements, full ENT examination and Müller maneuver.

RESULTS Review of the records indicates that 85.7% of the patients suffering from OSAS had increased body mass index (BMI >25 kg/m2), and in particular that all (100%) of the obese (BMI >30 kg/m2) patients were suffering from OSAS. Patients with increased neck circumference presented OSAS in a higher percentage (88.7%) than those with normal neck circumference (11.3%), while all of the patients with an increase in both neck circumference and BMI were suffering from the syndrome. Finally, it was observed that patients with both increased neck circumference and high BMI usually developed obstruction (i.e., pathological percentage of upper airway obstruction >75%) at more than one level of the upper respiratory tract: oropharynx, hypopharynx, soft palate and tongue base.

CONCLUSIONS Obesity is the most common predisposing factor for OSAS in adults. Increased neck circumference is an obesity index for OSAS, because of fat deposition along the upper airway. Fat deposition increases the collapsibility and movement of the lateral pharyngeal walls towards the midline, causing obstructive symptoms at more than one level of the upper respiratory tract. Treatment of OSAS in these patients is a very real challenge, and it consists of long-term use of CPAP in combination with multi-level surgery. Modification of the lifestyle and nutritional habits style is recommended, along with bariatric surgery.

Key words: Neck circumference, Obesity, Obstructive sleep apnea.

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