The presence of
obesity, defined as weight 20 per cent or more above ideal body weight or increased body fat content, significantly increases risk of pulmonary, cardiovascular, metabolic, and gastrointestinal problems.
Obesity is a major cause of shortened life expectancy. While
obesity is not essential for the development of the
obstructive sleep apnea syndrome, a significant percentage of patients with
obstructive sleep apnea are obese. When evaluating these patients who have
obstructive sleep apnea, it is important to search diligently for medical problems that are commonly found among the obese. While there is an increased incidence of obese patients among those who have
obstructive sleep apnea, the exact reason for this is uncertain. The study of
endorphins and
enkephalins may expand our understanding of
obesity, ventilatory regulation, and
obstructive sleep apnea. This may, in fact, enable us to understand better the interrelationship between
obesity and
obstructive sleep apnea. The role that
thyroid hormone,
testosterone, and
progesterone play in
obstructive sleep apnea has also been reviewed. Patients who have
obstructive sleep apnea should not be treated with
testosterone. All patients given
testosterone should be observed quite closely for the possible signs and symptoms of
obstructive sleep apnea.
Progesterone seems to be of some help in patients who have
obesity hypoventilation syndrome. Its effectiveness in patients with
obstructive sleep apnea is less clear. The
obesity hypoventilation syndrome as described by Burwell is relatively uncommon. Many of the manifestations of the
obesity hypoventilation syndrome, however, are found in patients with
obstructive sleep apnea. The recognition that the symptoms stem from underlying
obstructive sleep apnea offers great potential for
therapy.
Weight reduction is valuable
therapy for patients with
obesity and pulmonary dysfunction,
obesity and
obstructive sleep apnea, and
obesity hypoventilation syndrome.
Weight reduction and weight maintenance, while difficult, are essential in patients with
obesity,
obesity and
obstructive sleep apnea, and the
hypoventilation syndrome.
Obesity should be viewed as a medical problem deserving medical attention and long-term medical follow-up.