Chest
Volume 85, Issue 3, March 1984, Pages 435-436
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Selected Reports
Obstructive Sleep Apnea and Body Weight

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A patient with obstructive sleep apnea was monitored five times during three years while his weight fluctuated within a range of 26 kg. The number of apneas per hour of sleep varied from 59.6 at 111 kg of weight to 3.1 at 85 kg. The relation between apneas per hour of sleep and body weight was a logarithmic function. A modest decrease in weight was thus associated with a disproportionally larger decrease in the rate of apneas. Typical SaO2 levels during the apneic episodes also had a logarithmic relation with body weight. Apnea-related sinus bradycardia and sinus tachycardia were only present at the highest weight. The results suggested that dieting and weight loss lead to an improvement in sleep apnea and related sequelae.

Section snippets

CASE REPORT

A 52-year-old white man was referred for evaluation of uncontrolled daytime sleepiness. The patient reported a 19-year history of hypersomnia and falling asleep at inappropriate times. Symptoms were reported as relatively stable over the past ten years. The patient noted loud snoring and excessive sweating during sleep. Although he denied cataplexy, hypnagogic hallucinations and sleep paralysis, narcolepsy was diagnosed two years prior to our evaluation based solely on the reported hypersomnia.

COMMENTS

Diet manipulation and a subsequent reduction in weight is associated with a decrease in the number of obstructive apneas during sleep for the patient. The findings suggest the relation between apnea and body weight is best described as a logarithmic function. Beyond some critical weight, there is a rapid increase in the rate of apneas. The initial loss of weight thus provides the greatest reversal of this syndrome. Apparently ideal body weight need not be achieved to resolve the sleep apnea.

REFERENCES (7)

  • C Guilleminault

    Sleep and breathing

  • NZ Kerin et al.

    Cardiac dysrhythmias associated with obesity and sleep apnea

    Cardiovascular Med

    (1979)
  • C Guilleminault et al.

    Clinical overview of the sleep apnea syndromes

There are more references available in the full text version of this article.

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