REVIEWS  SLEEP DISORDERS 

Minerva Pneumologica 2009 December;48(4):307-29

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Obesity and sleep disordered breathing: diagnosis, clinical implications and management

Piper A. ^{1, 2}

¹ Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown NSW, Australia 2 Woolcock Institute of Medical Research University of Sydney, Sydney, Australia

Obesity is a major public health concern, significantly increasing cardiovascular morbidity and mortality. In recent years, a number of large scale epidemiological studies have highlighted the association between obstructive sleep apnea (OSA) and cardiovascular disorders. At present it is unclear if sleep apnea is a causal mechanism in the development and progression of cardiovascular disease, or if the two conditions are linked by a common entity, namely obesity. Nevertheless, current evidence suggests that OSA should be seen as a cardiovascular risk factor, which is modifiable with treatment. Even mild degrees of OSA have been associated with significant morbidity, adversely affecting daytime function and quality of life. The impact of OSA in patients with other disorders characterised by systemic inflammation such as COPD or morbid obesity may produce particularly poor outcomes if not recognised and treated in a timely fashion. Therefore it is important that clinicians maintain a high level of suspicion regarding the possibility of OSA in individuals with obesity. While the most effective treatment for OSA is continuous positive airway pressure, compliance with this treatment is poor, highlighting the need to develop better tolerated therapies for this disorder.