Chapter

Obesity and Lung Disease

Volume 19 of the series Respiratory Medicine pp 71-97

Date:

Pathogenesis of Obstructive Sleep Apnea in Obesity

  • Jason Paul KirknessAffiliated withDivision of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine Email author 
  • , Susheel P. PatilAffiliated withDivision of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine

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Abstract

Obstructive sleep apnea is a sleep-related breathing disorder characterized by repetitive upper airway obstruction and is associated with significant morbidity and mortality. Obesity is one of the primary modifiable risk factors for the management of patients with sleep apnea as there is a positive association between the increasing obesity prevalence and sleep apnea prevalence. Several mechanisms link obesity and sleep apnea pathogenesis, including the potential increase in additional mechanical load on the upper and lower respiratory systems from regional adiposity, possible effects of obesity-related inflammation on neuromuscular and neuroventilatory function of the upper airway, or a combination of these effects. By examining the relationship between obesity and obstructive sleep apnea as well as the mechanisms by which obesity may contribute to the development of sleep apnea and its related comorbidities, we can evaluate the effect of weight reduction on the management of sleep apnea.

Keywords

Sleep apnea risk factors Regional adiposity Upper airway pathophysiology Pharynx Weight loss Sleep-disordered breathing treatments Constant positive air pressure Bariatric surgery