Sleep Apnea and Sleep Disruption in Obese Patients

Alexandros Vgontzas, Tjiauw-ling Tan, Edward Bixler, Louis F. Martin, Duane Shubert, Anthony Kales

Research output: Contribution to journalArticle

357 Citations (Scopus)

Abstract

Objectives: To describe the frequency and severity of sleep apnea in obese patients without a primary sleep complaint and to assess the sleep patterns of obese patients without apnea and compare them with the sleep patterns of nonobese controls. Design and Setting: Prospective case series with historical controls in an obesity and sleep disorders clinic. Subjects: Two hundred obese women and 50 obese men (mean body mass index, 45.3) consecutively referred for treatment of their obesity and 128 controls matched for age and sex. Main Outcome Measures: Eight-hour sleep laboratory recording, including electroencephalogram, electro-oculogram, electromyogram, and respirations. Subjectively reported sleep-related symptoms and signs were also recorded. Results: Twenty men (40%) and six women (3%) demonstrated sleep apnea warranting therapeutic intervention. Another four men (8%) and 11 women (5.5%) showed sleep apneic activity that warranted recommendation for evaluation in the sleep laboratory. In contrast, none of the 128 controls demonstrated sleep apneic activity severe enough for therapeutic intervention. The best clinical predictors of sleep apnea in the obese population were severity of snoring, subjectively reported nocturnal breath cessation, and sleep attacks. Obese patients, both men and women, without any sleep-disordered breathing demonstrated a significant degree of sleep disturbance compared with nonobese controls. Wake time after sleep onset, number of awakenings, and percentage of stage 1 sleep were significantly higher in obese patients than in controls, while rapid eye movement sleep was significantly lower. Conclusion: Severely or morbidly obese men are at extremely high risk for sleep apnea and should be routinely evaluated in the sleep laboratory for this condition, while for severely or morbidly obese women the physician should include a thorough sleep history in the clinical assessment.

Original languageEnglish (US)
Pages (from-to)1705-1711
Number of pages7
JournalArchives of Internal Medicine
Volume154
Issue number15
DOIs
StatePublished - Aug 8 1994

Fingerprint

Sleep Apnea Syndromes
Sleep
Obesity
Women Physicians
Snoring
Sleep Stages
REM Sleep
Electromyography
Apnea
Signs and Symptoms
Electroencephalography
Respiration
Body Mass Index
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Vgontzas, Alexandros ; Tan, Tjiauw-ling ; Bixler, Edward ; Martin, Louis F. ; Shubert, Duane ; Kales, Anthony. / Sleep Apnea and Sleep Disruption in Obese Patients. In: Archives of Internal Medicine. 1994 ; Vol. 154, No. 15. pp. 1705-1711.
@article{a67ddfddcd534f6c92e1e4cc0149846a,
title = "Sleep Apnea and Sleep Disruption in Obese Patients",
abstract = "Objectives: To describe the frequency and severity of sleep apnea in obese patients without a primary sleep complaint and to assess the sleep patterns of obese patients without apnea and compare them with the sleep patterns of nonobese controls. Design and Setting: Prospective case series with historical controls in an obesity and sleep disorders clinic. Subjects: Two hundred obese women and 50 obese men (mean body mass index, 45.3) consecutively referred for treatment of their obesity and 128 controls matched for age and sex. Main Outcome Measures: Eight-hour sleep laboratory recording, including electroencephalogram, electro-oculogram, electromyogram, and respirations. Subjectively reported sleep-related symptoms and signs were also recorded. Results: Twenty men (40{\%}) and six women (3{\%}) demonstrated sleep apnea warranting therapeutic intervention. Another four men (8{\%}) and 11 women (5.5{\%}) showed sleep apneic activity that warranted recommendation for evaluation in the sleep laboratory. In contrast, none of the 128 controls demonstrated sleep apneic activity severe enough for therapeutic intervention. The best clinical predictors of sleep apnea in the obese population were severity of snoring, subjectively reported nocturnal breath cessation, and sleep attacks. Obese patients, both men and women, without any sleep-disordered breathing demonstrated a significant degree of sleep disturbance compared with nonobese controls. Wake time after sleep onset, number of awakenings, and percentage of stage 1 sleep were significantly higher in obese patients than in controls, while rapid eye movement sleep was significantly lower. Conclusion: Severely or morbidly obese men are at extremely high risk for sleep apnea and should be routinely evaluated in the sleep laboratory for this condition, while for severely or morbidly obese women the physician should include a thorough sleep history in the clinical assessment.",
author = "Alexandros Vgontzas and Tjiauw-ling Tan and Edward Bixler and Martin, {Louis F.} and Duane Shubert and Anthony Kales",
year = "1994",
month = "8",
day = "8",
doi = "10.1001/archinte.1994.00420150073007",
language = "English (US)",
volume = "154",
pages = "1705--1711",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "15",

}

Vgontzas, A, Tan, T, Bixler, E, Martin, LF, Shubert, D & Kales, A 1994, 'Sleep Apnea and Sleep Disruption in Obese Patients', Archives of Internal Medicine, vol. 154, no. 15, pp. 1705-1711. https://doi.org/10.1001/archinte.1994.00420150073007

Sleep Apnea and Sleep Disruption in Obese Patients. / Vgontzas, Alexandros; Tan, Tjiauw-ling; Bixler, Edward; Martin, Louis F.; Shubert, Duane; Kales, Anthony.

In: Archives of Internal Medicine, Vol. 154, No. 15, 08.08.1994, p. 1705-1711.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sleep Apnea and Sleep Disruption in Obese Patients

AU - Vgontzas, Alexandros

AU - Tan, Tjiauw-ling

AU - Bixler, Edward

AU - Martin, Louis F.

AU - Shubert, Duane

AU - Kales, Anthony

PY - 1994/8/8

Y1 - 1994/8/8

N2 - Objectives: To describe the frequency and severity of sleep apnea in obese patients without a primary sleep complaint and to assess the sleep patterns of obese patients without apnea and compare them with the sleep patterns of nonobese controls. Design and Setting: Prospective case series with historical controls in an obesity and sleep disorders clinic. Subjects: Two hundred obese women and 50 obese men (mean body mass index, 45.3) consecutively referred for treatment of their obesity and 128 controls matched for age and sex. Main Outcome Measures: Eight-hour sleep laboratory recording, including electroencephalogram, electro-oculogram, electromyogram, and respirations. Subjectively reported sleep-related symptoms and signs were also recorded. Results: Twenty men (40%) and six women (3%) demonstrated sleep apnea warranting therapeutic intervention. Another four men (8%) and 11 women (5.5%) showed sleep apneic activity that warranted recommendation for evaluation in the sleep laboratory. In contrast, none of the 128 controls demonstrated sleep apneic activity severe enough for therapeutic intervention. The best clinical predictors of sleep apnea in the obese population were severity of snoring, subjectively reported nocturnal breath cessation, and sleep attacks. Obese patients, both men and women, without any sleep-disordered breathing demonstrated a significant degree of sleep disturbance compared with nonobese controls. Wake time after sleep onset, number of awakenings, and percentage of stage 1 sleep were significantly higher in obese patients than in controls, while rapid eye movement sleep was significantly lower. Conclusion: Severely or morbidly obese men are at extremely high risk for sleep apnea and should be routinely evaluated in the sleep laboratory for this condition, while for severely or morbidly obese women the physician should include a thorough sleep history in the clinical assessment.

AB - Objectives: To describe the frequency and severity of sleep apnea in obese patients without a primary sleep complaint and to assess the sleep patterns of obese patients without apnea and compare them with the sleep patterns of nonobese controls. Design and Setting: Prospective case series with historical controls in an obesity and sleep disorders clinic. Subjects: Two hundred obese women and 50 obese men (mean body mass index, 45.3) consecutively referred for treatment of their obesity and 128 controls matched for age and sex. Main Outcome Measures: Eight-hour sleep laboratory recording, including electroencephalogram, electro-oculogram, electromyogram, and respirations. Subjectively reported sleep-related symptoms and signs were also recorded. Results: Twenty men (40%) and six women (3%) demonstrated sleep apnea warranting therapeutic intervention. Another four men (8%) and 11 women (5.5%) showed sleep apneic activity that warranted recommendation for evaluation in the sleep laboratory. In contrast, none of the 128 controls demonstrated sleep apneic activity severe enough for therapeutic intervention. The best clinical predictors of sleep apnea in the obese population were severity of snoring, subjectively reported nocturnal breath cessation, and sleep attacks. Obese patients, both men and women, without any sleep-disordered breathing demonstrated a significant degree of sleep disturbance compared with nonobese controls. Wake time after sleep onset, number of awakenings, and percentage of stage 1 sleep were significantly higher in obese patients than in controls, while rapid eye movement sleep was significantly lower. Conclusion: Severely or morbidly obese men are at extremely high risk for sleep apnea and should be routinely evaluated in the sleep laboratory for this condition, while for severely or morbidly obese women the physician should include a thorough sleep history in the clinical assessment.

UR - http://www.scopus.com/inward/record.url?scp=0028102601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028102601&partnerID=8YFLogxK

U2 - 10.1001/archinte.1994.00420150073007

DO - 10.1001/archinte.1994.00420150073007

M3 - Article

C2 - 8042887

AN - SCOPUS:0028102601

VL - 154

SP - 1705

EP - 1711

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 15

ER -