Identifying Comorbidities of Obesity
A 55-year-old woman presents to an obesity medicine specialist for evaluation. Her BMI is 37 kg/m2. She has tried multiple diets in the past, with some success, but finds that she always regains the weight she loses. Her past medical history is significant for hypertension, for which she takes metoprolol and hydrochlorothiazide. She has osteoarthritis in her knees and is planning to have knee replacement surgery in a few months. For knee pain she takes ibuprofen daily. On further questioning, she reveals that she has not been sleeping well. Her husband complains that she snores. She wakes up multiple times throughout the night, does not feel well rested in the morning, and falls asleep at her desk occasionally in the afternoon. She has been taking diphenhydramine occasionally to help her fall asleep at night.
KeywordsObesity Obstructive sleep apnea Snoring CPAP Osteoarthritis Hypertension
- 3.Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American academy of sleep medicine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479–504. https://doi.org/10.5664/jcsm.6506.CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American academy of sleep medicine. J Clin Sleep Med. 2012;8(5):597–619. https://doi.org/10.5664/jcsm.2172.CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Jonas D, Amick H, Feltner C, et al. Screening for obstructive sleep apnea in adults: evidence eeport and systematic review for the US preventive services task force. AHRQ Publication No. 14-05216-EF-1 2017.Google Scholar
- 9.Giles TL, Lasserson TJ, Smith BJ, et al. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev. 2006;1:CD001106.Google Scholar
- 19.Saunders KH, Igel LI, Shukla AP, Aronne LJ. Drug induced weight gain: rethinking our choices. J Fam Pract. 2016;65(11):780–8.Google Scholar