Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome

Yıl 2014, Cilt: 4 Sayı: 1, 11 - 15, 01.03.2014

Murat Ünlü Ayşe İriz Berçem Ayçiçek Doğan A. Seçil Kayalı Dinç Engin Dursun Adil Eryılmaz Aydın Acar

https://doi.org/10.2399/jmu.2014001003

Öz

Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data. Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2) and non-obese patient groups (n=32; BMI Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had an average score of Class II, with a statistically significant intergroup difference. In Muller's maneuver, the levels of obstruction in both the soft palate and oropharynx were higher in the obese patients with a statistically significant difference between two groups. When polysomnography results were examined, the average apnea-hypopnea index (AHI) score was determined to be 22.5 in the obese and 6.4 in the non-obese groups, respectively. Furthermore, average scores of rapid eye movement (REM) AHI in the non-obese and obese patients were 4.6 and 17.2 with a statistically significant difference between the groups. The average lowest oxygen saturation was 75.5% in the obese and 88% in the non-obese group, which represented a statistically significant difference between groups. In the obese group, the number of patients with REM-dependent OSAS was higher than in the non-obese group which attained a level of statistical significance. Conclusion: Our study indicated that obesity increases the severity of OSAS, in part due to significant narrowing of the airway at the level of the soft palate and oropharynx. Additionally, our study has shown that the risk of supine position-dependent OSAS and especially REM-dependent OSAS were notably higher in obese patients.

Anahtar Kelimeler

Obesity, obstructive sleep apnea syndrome

Obstrüktif uyku apne sendromu semptom ve bulguları ile obezite arasındaki ilişki

Öz

Amaç: Bu çalışmanın amacı obezitenin obstüktif uyku apne sendromu
(OUAS) üzerindeki etkilerini objektif ve subjektif veriler eşliğinde değerlendirmektir.
Yöntem: Toplam 70 hasta obez (n=38; VKİ > 35 kg/m2) ve obez olmayan
(n=32; VKİ < 30 kg/m2) olmak üzere iki gruba ayrıldı. Gruplar, Epworth
uykululuk skalası, modifiye Mallampati indeks skoru, orofarenks
ve yumuşak damaktaki tıkanıklığın seviyesi, boyun çevresi ve polisomnografi
sonuçları açısından karşılaştırıldı.
Bulgular: Obez hastalarda ortalama Mallampati skoru Sınıf III
iken obez olmayan hastalarda ortalama Mallampati skoru Sınıf II idi
ve gruplar arasında istatistiksel olarak anlamlı fark mevcut idi. Müller
manevrasında, hem yumuşak damakta hem de orofarenksteki tıkanıklığın
şiddeti obez hastalarda daha yüksek idi ve gruplar arasındaki fark
istatistiksel olarak anlamlı idi. Polisomnografi sonuçları incelendiğinde,
ortalama apne-hipopne indeksi (AHİ) puanı obez grupta 22.5 iken
obez olmayan grupta 6.4 idi. Ayrıca, obez olmayan ve obez hastalarda
hızlı göz hareketi (REM) AHİ ortalama skorları 4.6 ve 17.2 idi ve
gruplar arasında istatistiksel olarak anlamlı bir fark mevcuttu. Ortalama
en düşük oksijen doygunluğu açısından gruplar arasında istatistiksel
olarak anlamlı bir fark vardı ve doygunluk obez grupta %75.5 iken,
obez olmayan grupta %88 idi. Obez gruptaki REM bağımlı OUAS’lı
hasta sayısı obez olmayan gruptan istatistiksel olarak anlamlı düzeyde
daha yüksekti.
Sonuç: Bu çalışmada, obezitenin, kısmi olarak yumuşak damak ve orofarenks
seviyesinde havayolunun anlamlı derecede daralmasına neden
olarak, OUAS şiddetini arttırdığı ortaya konmuştur. Ek olarak, çalışmamızda,
supin pozisyon bağımlı OUAS ve REM bağımlı OUAS’ın obez
hasta grubunda anlamlı olarak daha yüksek düzeyde olduğu ortaya konmuştur.

Anahtar Kelimeler

Obezite, obstrüktif uyku apne sendromu

Kaynakça

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• This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
• NC-ND0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
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• Please cite this article as: Ünlü M, ‹riz A, Do¤an BA, Kayalı Dinç AS, Dursun E, Eryılmaz A, Acar A. Relationship between obesity with symptoms
• and findings of obstructive sleep apnea syndrome. J Med Updates 2014;4(1):11-15.