Sleep Medicine Reviews
Volume 4, Issue 5 , Pages 435-452 , October 2000

CLINICAL REVIEW ARTICLE: Weight loss as a treatment for obstructive sleep apnoea

  • VA Barvaux

      Affiliations

    • Pneumology Unit, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, 1200, Belgium
    • ,
  • G Aubert

      Affiliations

    • EEG Unit, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, 1200, Belgium
    • ,
  • DO Rodenstein

      Affiliations

    • Pneumology Unit, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, 1200, Belgium

References 

  1. National Institutes of Health . Consensus development panel on the health implications of obesity. Ann Intern Med. 1985;103:147
  2. Stunkard AJ. Current views on obesity. Am J Med. 1992;100:230–236
  3. Williamson D. Descriptive epidemiology of body weight and weight change in US adults. Ann Intern Med. 1993;119:646–649
  4. World Health Organization, Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva, 3-5 June 1997: 27–29
  5. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207–2212
  6. Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med. 1993;119:655–660
  7. Sharp JJ, Barrocas M, Chokroverty S. The cardio-respiratory effects of obesity. Clin Chest Med. 1980;1:103–118
  8. Guilleminault, C, Clinical features and evaluation of obstructive sleep apnoae, In: Kryger MH, Roth T, Dement WC (eds). Principles and Practice of Sleep Medicine. Philadelphia: WB Saunders 1994
  9. Harman EM, Wynne JW, Block AJ. The effect of weight loss in sleep-disordered breathing and oxygen desaturation in morbidly obese men. Chest. 1982;82:291–294
  10. Loube D, Gay P, Strohl K, Pack A, White D, Collop N. Indications for positive airway pressure treatment of adult obstructive sleep apnoea patients. A consensus statement. Chest. 1999;115:863–866
  11. Lavie, P, Sleep apnoea in industrial workers, In: Guilleminault C, Lugaresi E (eds). Sleep/Wake Disorders: Natural History, Epidemiology and Long-term Evolution. New York, Raven Press 1983; 127–135
  12. Telakivi T, Partinen M, Koskenvuo M, Salmi T, Kaprio J. Periodic breathing and hypoxia in snorers and controls. Acta Neurol Scand. 1987;76:69–75
  13. Gislason T, Almqvist M, Erikson G, Taube A, Boman G. Prevalence of Sleep Apnoea Syndrome among Swedish men: an epidemiological study. J Clin Epidemiol. 1988;41:571–576
  14. Cirignotta F, D»Alessandro R, Partinen M, et al.  Prevalence of every-night snoring and obstructive sleep apnoea among 30- to 69-year-old men in Bologna, Italy. Acta Neurol Scand. 1989;79:366–372
  15. Stradling J, Crosby J. Predictors and prevalence of Obstructive Sleep Apnoea and snoring in 1001 middle aged men. Thorax. 1991;46:85–90
  16. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  17. Olson LG, King MT, Hensley MJ, Saunders NA. A community study of snoring and sleep-disordered breathing: prevalence. Am J Respir Crit Care Med. 1995;152:711–716
  18. Bearpark H, Elliott L, Grunstein R, et al.  Snoring and sleep apnoea: a population study in Australian men. Am J Respir Crit Care Med. 1995;151:1459–1465
  19. Bixler BO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnoea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998;157:144–148
  20. Hoffstein V, Szalai JP. Predictive value of clinical features in diagnosing OSA. Sleep. 1993;16:118–122
  21. Richman RM, Elliott LM, Burns CM, Bearpak HM, Steinbeck KS, Caterson ID. The prevalence of obstructive sleep apnoea in an obese female population. Int J Obes Relat Metab Disord. 1994;18:173–177
  22. Ono T, Lowe A, Ferguson K, Fleetham J. Associations among upper airway structure, body position, and obesity in skeletal class I male patients with obstructive sleep apnoea. Am J Orthod Dentofacial Orthop. 1996;109:625–634
  23. Rollheim J, Osnes T, Miljeteig H. The relationship between obstructive sleep apnoea and body mass index. Clin Otolaryngol. 1997;22:419–442
  24. Schafer H, Berner S, Ewig S, Hasper E, Tasci S, Luderitz B. Dtsch Med Wochenschr. 1998;123:1127–1133
  25. Deegan PC, McNicholas WT. Predictive value of clinical features for obstructive sleep apnoea syndrome. Eur Respir J. 1996;9:117–124
  26. Zgierska, A, Koziej, M, Plywaczewski, R, Estimation of the value of a self-designed questionnaire in diagnosing patients with suspected obstructive sleep apnoea.Pneumonol–Alergol–Pol, 1997, 65, 802, 810
  27. Bassetti C, Aldrich MS. Sleep apnoea in acute cerebrovascular disease: final report on 128 patients. Sleep. 1999;22:217–223
  28. Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea. Eur Respir J. 1999;13:403–410
  29. Rajala R, Partinen M, Sure T, Pelkonen R, Huikuri K, Seppalainen AM. Obstructive sleep apnoea syndrome in morbidly obese patients. J Int Med. 1991;230:125–129
  30. Millman RP, Carlisle CC, McGarvey ST, Eveloff SE, Levinson PD. Body fat distribution and sleep apnoea severity in women. Chest. 1995;107:362–366
  31. Katz I, Stradling J, Slutsky AS, et al.  Do patients with obstructive sleep apnoea have thick necks?. Am Rev Respir Dis. 1990;141:1228–1231
  32. Ferguson K, Ono T, Lowe A, Ryan F, Fleetham J. The relationship between obesity and craniofacial structure in obstructive sleep apnoea. Chest. 1995;108:375–381
  33. Sforza E, Petiau C, Weiss T, Thibault A, Krieger J. Pharyngeal critical pressure in patients with obstructive sleep apnoea. Clinical implications. Am J Respir Crit Care Med. 1999;159:149–157
  34. Ryan CF, Love LL. Mechanical properties of the velopharynx in obese patients with obstructive sleep apnoea. Am J Respir Crit Care Med. 1996;154:806–812
  35. Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnoea. Am Rev Respir Dis. 1991;144:494–498
  36. Rodenstein D, Dooms G, Thomas Y, Liistro G, Stanescu D, Culée C, et al. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. Thorax. 1990;45:722–727
  37. Mortimore GL, Marshall I, Wraith PK, Sellar RJ, Douglas NJ. Neck and total body fat deposition in non obese and obese patients with sleep apnoea compared with that in control subjects. Am J Respir Crit Care Med. 1998;157:1280–1283
  38. Bates, DV, Respiratory Function in Disease, 3rd. Edn. Philadelphia: WB Saunders 1989; 100–102
  39. Collard P, Wilputte JY, Aubert G, Rodenstein DO, Frans A. The single-breath diffusing capacity for carbon monoxide in obstructive sleep apnoea and obesity. Chest. 1996;110:1189–1193
  40. Van de Graaff WB. Thoracic influence on upper airway patency. J Appl Physiol. 1988;65:2124–2131
  41. van Lunteren E, Haxhiu MA, Cherniack NS. Effects of tracheal airway occlusion on hyoid muscle lenght and upper airway volume. J Appl Physiol. 1989;67:2296–2303
  42. Bradley TD, Martinez D, Rutherford R, Lue F, Grossman R, Moldofsky H, et al. Physiological determinants of nocturnal arterial oxygenation in patients with obstructive sleep apnoea. J Appl Physiol. 1985;59:1364–1368
  43. Hakala K, Mustajoki P, Aittomaki J, Sovijarvi AR. Effect of weight loss and body position on pulmonary function and gas exchange abnormalities in morbid obese. Int J Obes Relat Metab Disord. 1995;19:343–346
  44. Weiner P, Waizman J, Weiner M, Rabner M, Magadle R, Zamit D. Influence of excessive weight loss after gastroplasty for morbid obesity on respiratory muscle performance. Thorax. 1998;58:39–42
  45. Gold AR, Schwartz AR, Wise RA, Smith PL. Pulmonary function and respiratory chemoÍsensitivity in moderately obese patients with sleep apnoea. Chest. 1999;103:1325–1329
  46. Sin DD, Jones RL, Man GC. Hypercapnic ventilatory response in patients with and without sleep apnoea. Chest. 2000;117:454–459
  47. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes. 1992;16:397–415
  48. Wing RR. Behavioral treatment of severe obesity. Am J Clin Nutr. 1992;55 (Suppl.):545S–554S
  49. Foreyt JP, Goodrick GK. Evidence for success of behaviour modification in weight loss and control. Ann Intern Med. 1993;119:698–701
  50. Wadden TA, Van Itallie TB, Blackburn GL. Responsible and irresponsible use of very low-calorie diets in the treatment of obesity. JAMA. 1990;263:83–85
  51. Simonneau G, Fartoukh M, Sitbon O, Humbert M, Jagot JL, Herve P. Primary pulmonary hypertension associated with the use of fenfluramine derivatives. Chest. 1998;144:195S–199S
  52. Graham DJ, Green L. Further cases of valvular heart disease associated with fenfluramine–phentermine. N Engl J Med. 1997;337:635
  53. Craighead LW, Stunkard AJ, O»Brien R. Behaviour therapy and pharmacotherapy of obesity. Arch Gen Psychiatry. 1981;38:763–768
  54. Hauptman JB, Jennet FS, Hartmann D. Initial studies in humans with the novel gastrointestinal lipase inhibitor tetrahydrolipstatin. Am J Clin Nutr. 1992;55 (Suppl.):309S–313S
  55. Drent ML, Vanderveen EA. Lipase inhibition: a novel concept in the treatment of obesity. Int J Obes. 1993;17:241–244
  56. Rand CSW, Mcgregor AMC. Successful weight loss following obesity surgery and perceived liability of morbid obesity. Int J Obes. 1991;15:577–579
  57. Kolanowsky J. Surgical treatment for morbid obesity. Br Med Bull. 1997;53:433–444
  58. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117:701–706
  59. Sagar PM. Surgical treatment of morbid obesity. Br J Surg. 1995;82:732–739
  60. Kolanowsky J. Gastroplasty for morbid obesity: the internist's view. Int J Obes. 1995;19 (Suppl. 3):S61–S65
  61. Partinen M, Guilleminault C. Daytime sleepiness and vascular morbidity at seven-year follow up in obstructive sleep apnoea. Chest. 1990;97:27–32
  62. Smith P, Gold A, Meyers D, Haponik E, Bleecker E. Weight loss in middly to moderately obese patients with obstructive sleep apnoea. Ann Intern Med. 1985;103:850–855
  63. Suratt PM, McTier R, Findley LJ, Pohl SL, Wilhoit SC. Changes in breathing and the pharynx after weight loss on Obstructive Sleep Apnea. Chest. 1987;92:631–637
  64. Aubert-Tulkens G, Culée C, Rodenstein DO. Cure of sleep apnoea syndrome after long-term nasal Continuous Positive Airway Pressure therapy and weight loss. Sleep. 1989;12:216–222
  65. Pillar G, Peled R, Lavie P. Recurrence of sleep apnoea without concomittant weight increase 7.5 years after weight reduction surgery. Chest. 1994;106:1702–1704
  66. Noseda A, Kempenaers C, Kerkhofs M, Houben JJ, Linkowski P. Sleep apnoae after 1 year domiciliary nasal Continuous Positive Airway Pressure and attempted weight reduction. Chest. 1996;109:138–143
  67. Ballester E, Badia JR, Lourdes H, Carrasco E, de Pablo J, Fornas C, et al. Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnoea–hypopnoea syndrome. Am J Respir Crit Care Med. 1999;159:495–501
  68. Peiser J, Lavie P, Ovnat A, Charuzzi I. Sleep apnoea syndrome in the morbidly obese as an indication for weight reduction surgery. Ann Surg. 1984;199:112–115
  69. Charuzzi I, Ovnat A, Peiser J, Saltz H, Weitzman S, Lavie P. The effect of surgical weight reduction on sleep quality in obesity-related sleep apnoea syndrome. Surgery. 1985;97:535–538
  70. Surgeman H, Fairman P, Baron P, Kwentus J. Gastric surgery for respiratory insufficiency of obesity. Chest. 1986;90:81–86
  71. Rubinstein I, Colapinto N, Rotstein L, Brown J, Hoffstein V. Improvement in upper airway function after weight loss in patients with obstructive sleep apnoea. Am Rev Respir Dis. 1988;138:1192–1195
  72. Pasquali R, Colella P, Cirignotta F, Mondini S, Geraldi R, Buratti P, et al.  Treatment of obese patients with obstructive sleep apnoea syndrome: effect of weight loss and interference of otorhinolarygoiatric pathology. Int J Obesity. 1990;14:207–217
  73. Schwartz A, Gold A, Schubert N, Stryzak A, Wise P, Permutt S, et al.  Effect of weight loss on upper airway collapsibility in obstructive sleep apnoea. Am Rev Respir Dis. 1991;144:494–498
  74. Suratt P, McTier R, Findley L, Pohl S, Wilhoit S. Effect of very low calorie diet with weight loss on obstructive sleep apnoea. Am J Clin Nutr. 1992;56:1825–1845
  75. Kiselak J, Clark M, Pera V, Rosenberg G, Redline S. The association between hypertension and sleep apnoea in obese patients. Chest. 1993;104:775–780
  76. Nahmias J, Kirschner M, Karetzky M. Weight loss and obstructive sleep apnoea and pulmonary function in obesity. N J Med. 1993;90:48–53
  77. Guilleminault C, Stoohs R, Clerk A, Cetel M, Maistros P. A cause of excessive daytime sleepiness: the upper airway resistance syndrome. Chest. 1993;104:665–666
  78. Montserrat JM, Badia JR. Upper airway resistance syndrome. Sleep Medicine Reviews. 1999;3:5–21
  79. Vgontzas A, Bixler E, Tan T, Kantner D, Martin L, Kales A. Obesity without sleep apnoea is associated with daytime sleepiness. Arch Intern Med. 1998;158:1333–1337
  80. Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnoea and the risk of traffic accidents. N Engl J Med. 1999;340:847–851
  81. Jenkinson C, Davies RJ, Mullins R, Stradling JR. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet. 1999;353:2000–2005

PII: S1087-0792(00)90114-X

doi: 10.1053/smrv.2000.0114

Sleep Medicine Reviews
Volume 4, Issue 5 , Pages 435-452 , October 2000

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