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Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese subjects
Abstract
Objective To investigate the prevalence of sleep breathing disorders, loud snoring and excessive daytime sleepiness in a group of obese subjects, and to identify the predictors of obstructive sleep apnea (OSA) severity in these patients.Subjects A total of 161 consecutive obese patients (body mass index (BMI)> or =30.0 kg/m(2)), ranging between 30.0 and 67.3, represented by 57 men and 104 women, aged 16-75 y. Forty (15 men and 25 women) age-matched (20-70 y) nonobese (BMI<27 kg/m(2)) volunteers were also recruited for the study.Measurements Respiratory function parameters, nocturnal sleep quality (evaluated by a specific questionnaire), nocturnal hypoventilation and OSA (evaluated by night polysomnography) were examined in all subjects. Anthropometric parameters (neck circumference, waist circumference, waist-to-hip ratio) were also investigated.Results Eighty-three obese patients (51.5% of the obese group) had a respiratory disturbance index (RDI)> or =10, corresponding to a moderate or severe sleep apnea. In particular, 24.8% (40/161), ie a quarter of all obese patients, were affected by severe OSA and this alteration was present in 42.1% of obese men (24/57) and in 15.4% (16/104) of obese women. When a stepwise multiple regression analysis was performed, neck circumference in men and BMI in women were shown to be the strongest predictors of sleep apnea. Twenty-nine percent of all obese subjects (40.3% of men and 23.1% of women) showed nocturnal hypoventilation; however, it was present as a unique breathing alteration in only 5% of the obese population. The percentage of patients having excessive daytime sleepiness was significantly higher than in nonobese subjects, even when only nonapneic obese patients were considered (P<0.001).Conclusion This study shows that OSA is present in more than 50% of a population of obese patients with a mean BMI higher than 40.0, this percentage being much higher than that commonly reported in previous studies, particularly in women. Neck circumference in men and BMI in women seem to be the strongest predictors of the severity of OSA in obese patients. Nocturnal hypoventilation seems to be present in more than 29% of a severe obese population. Moreover, this study indicates that morbid obesity can be associated with excessive daytime sleepiness even in the absence of sleep apnea.
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“The prevalence of OSA in obesity is about 50% (76), with much higher prevalence in morbidly obese individuals.(77)”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [76]
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Metadata
- Authors
- Resta, O., Foschino-Barbaro, M., Legari, G., Talamo, S., Bonfitto, P., Palumbo, A., Minenna, A., Giorgino, R., & De Pergola, G.
- Affiliations
- University of Bari Aldo Moro (IT)
- ORCID
- Resta, O
- Venue
- International Journal of Obesity
- Published
- 2001-05
- Volume
- 25
- Issue
- 5
- Pages
- 669-675
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2030390156
- Cited by
- 356
- References
- 41
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 22 · 2021: 12 · 2020: 18 · 2019: 19 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 26 · 2014: 26 · 2013: 14 · 2012: 21
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- obstructive sleep apnea, obesity, snoring, excessive daytime sleepiness, nocturnal hypoventilation, sleep-disordered breathing, neck circumference, body mass index, sex differences, respiratory disturbance index, polysomnography, anthropometric predictors, obese women
- MeSH terms
- Adolescent, Adult, Aged, Anthropometry, Body Composition, Circadian Rhythm, Female, Humans, Hypoventilation, Male, Middle Aged, Obesity, Risk Factors, Sleep Apnea Syndromes, Sleep Wake Disorders, Snoring, Body Mass Index, Prevalence, Polysomnography
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