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

İRİZ, Ayşe; DİNÇ KAYALI, A. Seçil; DOĞAN AYÇİÇEK, Berçem; DURSUN, Engin; AYDIN ACAR, ÇİĞDEM; ÜNLÜ, Murat; Eryılmaz, Adil

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

Murat ÜNLÜ, (Medline Hastanesi, Kulak Burun Boğaz Kliniği, Aydın, Türkiye)

Ayşe İRİZ, (Sağlık Bakanlığı, Ankara Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye)

Berçem DOĞAN AYÇİÇEK, (Ankara Numune Eğitim ve Araştırma Hastanesi, İç Hastalıkları Anabilim Dalı, Ankara, Türkiye)

A. Seçil DİNÇ KAYALI, (Sağlık Bakanlığı, Ankara Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye)

Engin DURSUN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, Rize, Türkiye)

Adil ERYILMAZ, (Sağlık Bakanlığı, Ankara Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye)

ÇİĞDEM AYDIN ACAR (Sağlık Bakanlığı, Ankara Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye)

Journal of Medical Updates

2 0

Yıl: 2014 Cilt: 4 Sayı: 1 Sayfa Aralığı: 11 - 15 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

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

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 Kelime:

Konular: Genel ve Dahili Tıp

Obstrüktif uyku apne sendromu semptom ve bulguları ile obezite arasındaki ilişki

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<30 kg/m2). The Epworth sleepiness scale scores, modified Mallampati index scores, levels of obstruction in the oropharynx and soft palate, neck circumference and polysomnography findings between two groups were compared.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 Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Köktürk O. Obstrüktif uyku apne sendromu epidemiyolojisi. Tüberküloz ve Toraks Dergisi 1998;46:193-201.
2. Liu PY, Caterson ID, Grunstein RR, Handelsman DJ . Androgens, obesity and sleep-disordered breathing in men. Endocrinol Metab Clin North Am 2007;36:349-63.
3. Collop NA, Adkins D, Phillips BA. Gender differences in sleep and sleep-disordered breathing. Clin Chest Med 2004;25:257- 68.
4. Calle EE, Thun MJ , Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999;341:1097-105.
5. Samsoon GLT, Young J RB. Difficult tracheal intubation: a ret- rospective study. Aneasthesia 1987;42:487-90.
6. Mokhlesi B. Obesity hypoventilation syndrome: a state of the art review. Respir Care 2010;55:1347-62.
7. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ , Fell R, Kaplan O. Sleep disordered breathing in community-dwelling elderly. Sleep 1991;14:486-95.
8. J ebb SA. Vücut bileﬂiminin ölçülmesi: laboratuardan klini¤e. In: Kopelman PG, Stock MJ , editors. Klinik obezite. 1. Bask. stan- bul: AND Yaynclk; 2000. p.18-49.
9. Stevens J , Cai J , Pamuk ER, Williamson DF, Thun MJ , Wood JL. The effect of age on the association between body-mass index and mortality. N Engl J Med 1998;338:1-7.
10. Newman AB, Nieto FJ , Guidry U, et al.; Sleep Heart Health Study Research Group. Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study. Am J Epidemiol 2001;154:50-9.
11. Oranzo JA, Scott J G. Diagnosis and treatment of obesity in adults: an applied evidence-based review. J Am Board Fam Pract 2004;17:359-69.
12. Degache F, Sforza E, Dauphinot V, et al. Relation of central fat mass to obstructive sleep apnea in the elderly. Sleep 2013;36:501-7.
13. Resta O, Foschino-Barbaro MP, Legari G, et al. Sleep related breathing disorders, loud snoring and excessive daytime sleepi- ness in obese subjects. Int J Obes Relat Metab Disord 2001;25: 669-75.
14. Terris DJ , Hanasono MM, Liu YC. Reliability of the Muller maneuver and its association with sleep-disordered breathing. Laryngoscope 2000;110:1819-23.
15. Chierakul N1, Chaipattarapol C, Ruttanaumpawan P, Nana A, Naruman C, Tangchityongsiva S. Comparison of clinical and polysomnographiccharacteristicsof non-obese and obese patients with obstructive sleep apnea. J Med Assoc Thai 2007;90:48-53.
16. Oksenberg A, Silverberg DS, Arons E, Radwan H. The sleep supine position has a major effect on optimal nasal continuous positive airway pressure : relationship with rapid eye movements and non-rapid eye movements sleep, body mass index, respirato- ry disturbance index, and age. Chest 1999;116:1000-6.
17. Mancini M, Aloe F, Tavares S. Sleep apnea in obese. [Article in Portuguese] Arquivos Brasileiros de Endocrinologia & Metabologia 2000;44:81-90.

APA	ÜNLÜ M, İRİZ A, DOĞAN AYÇİÇEK B, DİNÇ KAYALI A, DURSUN E, Eryılmaz A, AYDIN ACAR Ç (2014). Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. , 11 - 15.
Chicago	ÜNLÜ Murat,İRİZ Ayşe,DOĞAN AYÇİÇEK Berçem,DİNÇ KAYALI A. Seçil,DURSUN Engin,Eryılmaz Adil,AYDIN ACAR ÇİĞDEM Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. (2014): 11 - 15.
MLA	ÜNLÜ Murat,İRİZ Ayşe,DOĞAN AYÇİÇEK Berçem,DİNÇ KAYALI A. Seçil,DURSUN Engin,Eryılmaz Adil,AYDIN ACAR ÇİĞDEM Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. , 2014, ss.11 - 15.
AMA	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. . 2014; 11 - 15.
Vancouver	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. . 2014; 11 - 15.
IEEE	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç "Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome." , ss.11 - 15, 2014.
ISNAD	ÜNLÜ, Murat vd. "Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome". (2014), 11-15.

APA	ÜNLÜ M, İRİZ A, DOĞAN AYÇİÇEK B, DİNÇ KAYALI A, DURSUN E, Eryılmaz A, AYDIN ACAR Ç (2014). Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. Journal of Medical Updates, 4(1), 11 - 15.
Chicago	ÜNLÜ Murat,İRİZ Ayşe,DOĞAN AYÇİÇEK Berçem,DİNÇ KAYALI A. Seçil,DURSUN Engin,Eryılmaz Adil,AYDIN ACAR ÇİĞDEM Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. Journal of Medical Updates 4, no.1 (2014): 11 - 15.
MLA	ÜNLÜ Murat,İRİZ Ayşe,DOĞAN AYÇİÇEK Berçem,DİNÇ KAYALI A. Seçil,DURSUN Engin,Eryılmaz Adil,AYDIN ACAR ÇİĞDEM Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. Journal of Medical Updates, vol.4, no.1, 2014, ss.11 - 15.
AMA	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. Journal of Medical Updates. 2014; 4(1): 11 - 15.
Vancouver	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome. Journal of Medical Updates. 2014; 4(1): 11 - 15.
IEEE	ÜNLÜ M,İRİZ A,DOĞAN AYÇİÇEK B,DİNÇ KAYALI A,DURSUN E,Eryılmaz A,AYDIN ACAR Ç "Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome." Journal of Medical Updates, 4, ss.11 - 15, 2014.
ISNAD	ÜNLÜ, Murat vd. "Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome". Journal of Medical Updates 4/1 (2014), 11-15.