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Effect of weight loss on upper airway size and facial fat in men with obstructive sleep apnoea.
MedLine Citation:
PMID:  21680567     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background Obstructive sleep apnoea (OSA) is commonly associated with obesity and can be improved by weight loss. Changes in upper airway size related to regional fat loss may mediate the improvement in OSA. This study aimed to assess changes in upper airway size and regional facial and abdominal fat with weight loss and their association with OSA improvement. Methods Middle-aged obese men with moderate-to-severe OSA underwent a 24-week sibutramine-assisted weight loss trial. Polysomnography and CT of the head and neck were performed at baseline and 24&emsp14;weeks. The upper airway lumen and facial and parapharyngeal fat were measured with image analysis software. Results Post-intervention there was a significant reduction in weight (-7.8±4.2&emsp14;kg, p<0.001) and apnoea-hypopnoea index (AHI) (-15.9±20.5&emsp14;events/h, p<0.001). Velopharyngeal airway volume significantly increased from baseline (5.3±0.4 to 6.3±0.3&emsp14;cm(3), p<0.01) and facial and paraphayngeal fat volume significantly reduced. A reduction in upper airway length was associated with improvement in AHI (r=0.385, p=0.005). The variance in AHI improvement was best explained by changes in upper airway length and visceral abdominal fat (R(2)=0.31, p=0.004). Conclusions Weight loss increases velopharyngeal airway volume, but changes in upper airway length appear to have a greater influence on the reduction in apnoea frequency. Inter-individual variability in the effects of weight loss on OSA severity cannot be explained in terms of changes in upper airway structure and local fat deposition alone.
Authors:
Kate Sutherland; Richard W W Lee; Craig L Phillips; George Dungan; Brendon J Yee; John S Magnussen; Ronald R Grunstein; Peter A Cistulli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-15
Journal Detail:
Title:  Thorax     Volume:  -     ISSN:  1468-3296     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
NHMRC Centre for Sleep Health (CIRUS), Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
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