OSA Case Study

* Obstructive Sleep Apnea is when the pharyngeal airway collapses or narrows respectively during sleep. It is accompanied by excessive daytime sleepiness and risk for cardiovascular disease. Risk factors for OSA include obesity, large soft palate/tongue, the male sex, and aging.

Towards the end of his medical training in the early 1980s, Gokhan Hotamisligil was working on a unique tumor case on a patient and found they were comprised primarily of fat cells. The fatty tumors were due to a rare condition, Proteus Syndrome. Working in the field of metabolic regulation Hotamisligil began to explore the underlying pathways for insulin resistance. In his dissertation he discovered that the fat tissue of obese animals and humans were capable of producing inflammatory mediators. His research helped shape the current view of fat tissue as a “discrete, active organ in its own right, continuously exchanging messages with the rest of the body by way of the bloodstream.” By early 2002 Hotamisligil and his laboratory made

The consequences of undiagnosed and untreated OSA are medically serious and economically costly. Continuous positive airway pressure (CPAP) is considered the gold standard of treatment for OSA along with lifestyle modifications. With CPAP use, patients can reduce their healthcare utilization and save money by reducing the impact of OSA symptoms, comorbidities, and motor vehicle accidents. Direct costs associated with comorbidities include increased medical expenses, emergency room visits, hospital inpatient visits, medication use, and mortality rates (American Academy of Sleep Medicine, 2016).

OhioHealth Sleep Services can diagnose a variety of sleep disorders, including sleep apnea, narcolepsy, insomnia, and restless leg syndrome. Sleep apnea is a frequently occurring disorder involving the collapse of the airway during sleep, causing snoring and cessation of breathing. Sleep disorders can contribute to several health risks such as hypertension, obesity, heart attack, diabetes, and stroke. Our caring and experienced sleep specialists provide you with the high quality and comprehensive medical care you deserve.

OSA is characterized by repeated episodes of either partial or complete obstruction of the upper airways during sleep due to excessive relaxation of airway musculature, which leads to cessation

Components, for example, decreased action levels and expanded ravenousness, especially for refined sugars, might possibly add to weight pick up in OSA patients. Whether OSA inclines to particular collection of instinctive fat stays to be resolved. CPAP treatment of OSA diminishes the measure of instinctive fat (as measured by stomach CT examining), even in patients without huge weight reduction. At long last, there are information demonstrating significant cover in hereditary substrates in the middle of OSA and weight. Patel et al reported a critical connection in the middle of's AHI and human adiposity measures (going from 0.57 to 0.61), proposing that heftiness could clarify about 40% of the hereditary change in rest apnea. In another study, Popko et al demonstrated that polymorphisms (Arg/Arg and Gln/Arg when contrasted and Gln/Gln) of the leptin receptor, which is included in vitality homeostasis and body weight regulation, are essentially related with both OSA and stoutness when contrasted and sound controls. These studies propose that hereditary polymorphisms may impact both rest apnea and corpulence, and may be essentially interrelated in the improvement of these

Obesity Hypoventilation Syndrome is characterized by obesity, hypercapnia, and respiratory issues while asleep that occurs in the absence of any other pathology that could cause respiratory failure (Castillejo et al., 2015, p. 63). It is usually defined as an awake PaCO2 of greater than 45mmHg and a body mass index of greater than 30kg (Piper, 2015, p. 9). This is a life threatening disorder that can lead to death if not treated properly and aggressively. Treatments include CPAP (continuous positive airway pressure), NIV (non-invasive ventilation), and lifestyle changes such as weight loss and exercise. Obesity Hypoventilation Syndrome is becoming more prevalent in our society due to the increased occurrence of morbid obesity. Obesity is recognized

2. The majority of sufferers have Obstructive Sleep Apnea (OSA). OSA is when the muscles around the base of your tongue and uvula relax during sleep and move backwards to obstruct your airway. This places stress on the heart, elevates blood pressure, and prevents restful sleep.

1994). Leptin is secreted primarily by adipocytes, proportionally to fat cell mass, and contributes to energy metabolism. Leptin will affect the energy balance by acting on the brain. Leptin can activate, directly or indirectly, specific centers in the hypothalamus to decrease food intake, to increase any energy expenditure, to influence the glucose, lipid metabolism, and alter neuroendocrine function (Campfield, Smith et al. 1995). Leptin resistance, in regards to obesity, was coined due to the increased leptin levels with no impact on regulating energy homeostasis. Leptin resistance causes insulin resistance and the accumulation of lipids is a direct result of the reduction of lipid oxidation in insulin-sensitive organs; shown in preclinical and clinical experiments with obese rodents and humans. However, the mechanisms that may lead to leptin resistance are still being researched (Mori, Hanada et al.

However, some study showed controversial result. A cohort study done by similar method as (O’Brien et al., 2006) in UK with population size 825 showed a totally different result in acute lung injury, no association between BMI and mortality rate was found. Moreover, in severely obese patients the mortality rate was increased. The limitation of the study may have affect the result, the sample size of underweight and severely obese patients are relative small, also the diagnosis of acute lung injury in the most obese patients can be difficult due to body habitus.

Sleep Apnea is a disorder in which one may have one or more pauses in breathing or shallow breaths while sleeping. It is a breathing disorder that is quite common amongst people with cardiovascular disease. Observational studies have demonstrated a correlation between obstructive sleep apnea (OSA) and the risk of hypertension. There are factors that have been reported that show prevalence of an increase risk for sleep apnea, such as weight, age and gender. Most people who have sleep apnea are not aware of it because it only occurs during sleep. It can affect physiological events of the body, which in turn can influence ones blood pressure.

Positive airway pressure (PAP) is the standard treatment for patients with moderate-to-severe obstructive sleep apnea (OSA); a sleep-related breathing disorder (SRBD) characterized by episodic complete or partial upper airway occlusion during sleep.1 Over the past years, the relationship between SRBD and cardiac arrhythmias have been thoroughly investigated.2-7 Previous studies have shown that obstructive sleep apnea syndrome (OSAS) predisposes to clinically significant nocturnal impairment of the cardiac autonomic function and such impairment correlated with the severity of OSAS.8-11 The respiratory event-related cyclic hypoxemia and arousal characteristic of OSA causes dysregulation in the autonomic nervous system (ANS) in the form of enhanced sympathetic activity, such impairment is thought to be the substrate

Obesity is a condition where the body amasses an excessive amount of adipose tissue (DeAngelo, Kalumuck, & Adlin, 2014). The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health”. It is an avoidable disease that has increased almost twofold since 1980 (Obesity and Overweight, 2014). Obesity affects myriad body systems or parts of anatomy, including the abdomen, blood vessels, circulatory system, endocrine system, gastrointestinal system, heart, intestines, joints, psychic-emotional system, respiratory system, and stomach (DeAngelo, Kalumuck, & Adlin). Many diseases arise due to obesity complications, such as

Inflammation is significant as the causative path via which obesity predisposes women to pre-eclampsia. Abnormal adipokine production and infiltration of inflammatory cells portray adipose tissue de-function. Visceral fat produces more C-reactive protein and inflammatory cytokines compared to subcutaneous fat, furthermore it donates more to oxidative stress(114).Obesity and insulin resistance are inflammatory conditions, portrayed by greater than before production of proinflammatory cytokines besides of inflammatory signaling pathways activation (181).

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