OBESITY A PROBLEM? YOUR ANSWER CAN COME TO YOU IN YOUR SLEEP.

A new article "Chronic intermittent hypoxia caused by obstructive sleep apnea may play an important role in explaining the morbidity-mortality paradox of obesity." in Medical Hypothesis (abstrct below) may explain the problems of morbidity and mortality related to obesity. Obesity has become pandemic according to the article and "threatens the health of millions of people and is associated with numerous morbidities such as hypertension, type II diabetes mellitus, dyslipidemia, cor pulmonale, gallbladder disease, obstructive sleep apnea (OSA), certain cancers, osteoarthritis, increased surgical risk and postoperative complications, lower extremity venous and/or lymphatic problems, pulmonary embolism, stroke/cerebrovascular diseases and coronary arterial disease"

The article sttes that it may be the repetitive intermittent hypoxia from sleep apnea that is responsible for the adverse health effects of obesity.

TREATMENT OF SLEEP APNEA HAS BEEN SHOWN TO HELP A WIDE ASSORTMENT OF MEDICAL CONDITIONS ASSOCIATED WITH OBESITY. UNFORTUNATELY MOST PATIENTS DO NOT TOLERATE CPAP. IN PATIENTS THAT DO NOT TOLERATE CPAP ORAL APPLIANCES MAY BE A LIFE-SAVING THERAPY.

Med Hypotheses. 2010 Sep 3. [Epub ahead of print]

Ozeke O, Ozer C, Gungor M, Celenk MK, Dincer H, Ilicin G.

Bayindir Hospital Sogutozu, Department of Cardiology, Ankara, Turkey.
Abstract
Obesity has reached global pandemic that threatens the health of millions of people and is associated with numerous morbidities such as hypertension, type II diabetes mellitus, dyslipidemia, cor pulmonale, gallbladder disease, obstructive sleep apnea (OSA), certain cancers, osteoarthritis, increased surgical risk and postoperative complications, lower extremity venous and/or lymphatic problems, pulmonary embolism, stroke/cerebrovascular diseases and coronary arterial disease. Despite all these adverse associations, numerous studies and meta-analyses have documented an "obesity paradox" in which overweight and obese population with established cardiovascular disease have a better prognosis than do their lean counterparts. There are potential and plausible explanations offered by literature for these puzzling data; however, it still remains uncertain whether this phenomenon is attributable to a real protective effect of high body fat mass. In recent years, the survival advantage of patients with OSA, combined with the potential cardioprotective effects of chronic intermittent hypoxia, raise the possibility that apneas during sleep may activate preconditioning-like cardioprotective effect. Chronic intermittent hypoxia, one of the physiological markers of OSA, is characterized by transient periods of oxygen desaturation followed by reoxygenation, and is a major cause of its systemic harmful (oxidative stress, inflammation, sympathetic activity, vasculature remodelling and endothelial dysfunction) and/or protective (preconditioning-like cardioprotective) effects. Since many OSA subjects are obese, and obesity is an independent risk factor for many comorbidities associated with OSA; and also most OSA has never been diagnosed in obese patients, we hypothesed that the chronic intermittent hypoxia caused by OSA in obese patients may be one of the underlying mechanisms in morbi-mortality paradox of obesity.

PMID: 20822856 [PubMed - as supplied by publisher]