Obesity Surgery

, Volume 17, Issue 5, pp 689–697

Relationship between the Upper Airway and Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women

  • A. Santiago-Recuerda
  • F. J. Gómez-Terreros
  • P. Caballero
  • A. Martín-Duce
  • M. J. Soleto
  • G. Vesperinas
  • E. Pérez-Fernández
  • J. Villamor
  • R. Álvarez-Sala
Article

DOI: 10.1007/s11695-007-9120-4

Cite this article as:
Santiago-Recuerda, A., Gómez-Terreros, F.J., Caballero, P. et al. OBES SURG (2007) 17: 689. doi:10.1007/s11695-007-9120-4

Background

The authors studied changes in the upper airway in morbidly obese women and the relationship to sleep apnea-hypopnea syndrome (OSAS).

Methods

Patients underwent a cardiorespiratory polygraphic study, respiratory function test (spirometry, plethysmography, maximum inspiratory pressures and arterial blood gas analysis), and computed tomographic studies of the upper airway.

Results

40 morbidly obese women being evaluated for bariatric surgery (mean age 39.6 ±–.6 years old, BMI 48.7 ±–.6 kg/m2) were studied. 37 women had OSAS, and 14 had severe OSAS. Results on respiratory function tests were normal. BMI and weight had a positive correlation with apnea-hypopnea index (AHI), apnea index (AI), desaturation index (DI), lowest oxygen saturation and CT90. Uvula diameter had a negative correlation with FEV1, FVC, VC IN and a positive correlation with TLC. Retropharynx soft tissue at the retropalatal level had a negative correlation with FEV1, FVC and VC IN. The oropharynx area at maximal inspiration (total lung capacity) obtained a negative correlation with the AHI (r– −0.423, P––.044), AI (r– −0.484, P––.042) and DI (r– −0.484, P––.019).

Conclusions

Prevalence of OSAS in morbidly obese women is very high. Our results show the significant correlation between BMI and AHI in morbidly obese women. Uvula diameter and retropharynx soft tissue are the upper airway parameters with higher relationship with pulmonary function. A reduction in the cross-sectional area of the airway at the level of the oropharynx could be related to the severity of OSAS in morbidly obese women.

Key words

Upper airwaymorbid obesityOSASsleep apneacomputed tomographywomen

Abbreviations

FRC

functional residual capacity

ERV

expiratory reserve volume

FEV1

forced expiratory volume in 1 second

FVC

forced vital capacity

VC IN

vital capacity on inspiration

TLC

total lung capacity

RT

retropharyngeal tissue

CT90

% of time with O

DI

desaturation index

PO.1

mouth occlusion pressure at 100 ms beginning inspiratioin

TTmu

tension-time index of inspiratory muscles

Rtot

total airway resistance

PImax

maximal static inspiratory pressure

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • A. Santiago-Recuerda
    • 1
    • 7
  • F. J. Gómez-Terreros
    • 2
  • P. Caballero
    • 3
  • A. Martín-Duce
    • 4
  • M. J. Soleto
    • 3
  • G. Vesperinas
    • 5
  • E. Pérez-Fernández
    • 6
  • J. Villamor
    • 1
  • R. Álvarez-Sala
    • 1
  1. 1.Dept. of PneumologyLa Paz HospitalMadridSpain
  2. 2.Dept. of PneumologyPríncipe de Asturias Hospital, Alcalá de HenaresMadridSpain
  3. 3.Dept. of RadiologyLa Princesa HospitalMadridSpain
  4. 4.Dept. of SurgeryAlcalá de Henares UniversityMadridSpain
  5. 5.General SurgeryLa Paz HospitalMadridSpain
  6. 6.Dept. of StatisticsLa Paz HospitalMadridSpain
  7. 7.MadridSpain