Abstract
Obesity is defined as a body mass index (BMI) ≥ 30 kg/m2 and is a well-known risk factor for obstructive sleep apnea (OSA). One of the hypothesis explaining obesity as an important risk factor for OSA is that excessive fat in the pharyngeal airway plays an important role in upper airway collapse. As excessive adipose tissue may be deposited in all parts of soft tissue surrounding the collapsible segment of the pharynx, the level of obstruction varies. This chapter focused on the role of BMI in epiglottis collapse.
Epiglottis collapse was mostly evaluated with drug-induced sleep endoscopy. The prevalence varied between 20% and 42%. With current literature, it can be concluded that increasing BMI is no risk factor for epiglottis obstruction.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Quetelet, Adolphe. Most widely held works by Adolphe Quetelet. 1796–1874. http://www.worldcat.org/identities/lccn-n50050539/.
Obesity and overweight. Key facts. Quetelet, Adolphe 1796–1874. Most widely held works by Adolphe Quetelet. http://www.worldcat.org/identities/lccn-n50050539/.
White DP. The pathogenesis of obstructive sleep apnea: advances in the past 100 years. Am J Respir Cell Mol Biol. 2006;34(1):1–6.
Malhotra A, White DP. Obstructive sleep apnoea. Lancet. 2002;360(9328):237–45.
De Raaff CAL, Pierik AS, Coblijn UK, De Vries N, Bonjer HJ, Van Wagensveld BA. Value of routine polysomnography in bariatric surgery. Surg Endosc. 2017;31(1):245–8.
Horner RL, Mohiaddin RH, Lowell DG, et al. Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnea and weight matched controls. Eur Respir J. 1989;2:613–22.
Shelton KE, Gay SB, Hollowell DE, et al. Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am Rev Respir Dis. 1993;148:195–200.
Schwab RJ, Pasirtstein M, Pierson R, et al. Identificatin of upper airway anatomic risk factors for obstructive sleep apnea with volumetric mangetic resonance imaging. Am J Respir Crit Care Med. 2003;18:522–30.
Lin Z, Zhang H, Wang T, Li C, Bai Z. The upper airway MRI of obstructive sleep apnea patients. Zhonghua Er Bi Yan Hou Ke Za Zhi. 2000;35(1):51–4.
Nashi N, Kang S, Barkdull GC, et al. Lingual fat at autopsy. Laryngoscopy. 2007;117:1467–73.
Mortimore IL, Marshall I, Wraith PK, et al. Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects. Am J Respir Crit Car Med. 1998;157:280–3.
Gazayerli M, Bliebel W, Elhorr A, Elakkary E. The shape of the epiglottis reflects improvement in upper airway obstruction after weight loss. Obes Surg. 2006;16(7):945–7.
Kuo I, Hsin L, Lee L, et al. Prediction of epiglottic collapse in obstructive sleep apnea patients: epiglottic length. Nat Sci Sleep. 2021;13:1985–92.
Ravesloot MJ, de Vries N. One hundred consecutive patients undergoing drug-induced sleep endoscopy: results and evaluation. Laryngoscope. 2011;121(12):2710–6.
Lan MC, Lui SYC, Lan MY, Modi R, Capasso R. Lateral pharyngeal wall collapse associated with hypoxemia in obstructive sleep apnea. Laryngoscope. 2015;125(10):2408–12.
Wong SJ, Luitje ME, Karelsky S. Patterns of obstruction on DISE in adults with obstructive sleep apnea change with BMI. Laryngoscope. 2021;131(1):224–9.
Woo HJ, Lim JH, Ahn JC, et al. Characteristics of obstructive sleep apnea patients with a low body mass index: emphasis on the obstruction site determined by drug-induced sleep endoscopy. Clin Exp Otorhinolaryngol. 2020;13(4):415–21.
Vroegop AV, Vanderveken OM, Boudewyns AN, et al. Drug-induced sleep endoscopy in sleep-disordered breathing: report on 1,249 cases. Laryngoscope. 2014;124:797–802.
Sung CM, Tan SH, Shin MH, et al. The site of airway collapse in sleep apnea, its associations with disease severity and obesity, and implications for mechanical interventions. Am J Respir Crit Care Med. 2021;204(1):103–6.
Kim HY, Sung CM, Jan HB, Kim HC, Lim SC, Yang HC. Patients with epiglottic collapse showed less severe obstructive sleep apnea and good response to treatment other than continuous positive airway pressure: a case-control study of 224 patients. J Clin Sleep Med. 2021;17(3):413–9.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
de Raaff, C.A.L. (2023). The Role of Obesity in Epiglottis Collapse. In: Delakorda, M., de Vries, N. (eds) The Role of Epiglottis in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-031-34992-8_12
Download citation
DOI: https://doi.org/10.1007/978-3-031-34992-8_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-34991-1
Online ISBN: 978-3-031-34992-8
eBook Packages: MedicineMedicine (R0)