Murat ÜNLÜ, Ayşe İRİZ, Berçem Ayçiçek DOĞAN, A. Seçil Kayalı DİNÇ, Engin DURSUN, Adil ERYILMAZ, Aydın ACAR

Obstrüktif uyku apne sendromu semptom ve bulguları ile obezite arasındaki ilişki

Amaç: Bu çalışmanın amacı obezitenin obstüktif uyku apne sendromu (OUAS) üzerindeki etkilerini objektif ve subjektif veriler eşliğinde değerlendirmektir. Yöntem: Toplam 70 hasta obez (n=38; VKİ > 35 kg/m2) ve obez olmayan (n=32; VKİ < 30 kg/m2) olmak üzere iki gruba ayrıldı. Gruplar, Epworth uykululuk skalası, modifiye Mallampati indeks skoru, orofarenks ve yumuşak damaktaki tıkanıklığın seviyesi, boyun çevresi ve polisomnografi sonuçları açısından karşılaştırıldı. Bulgular: Obez hastalarda ortalama Mallampati skoru Sınıf III iken obez olmayan hastalarda ortalama Mallampati skoru Sınıf II idi ve gruplar arasında istatistiksel olarak anlamlı fark mevcut idi. Müller manevrasında, hem yumuşak damakta hem de orofarenksteki tıkanıklığın şiddeti obez hastalarda daha yüksek idi ve gruplar arasındaki fark istatistiksel olarak anlamlı idi. Polisomnografi sonuçları incelendiğinde, ortalama apne-hipopne indeksi (AHİ) puanı obez grupta 22.5 iken obez olmayan grupta 6.4 idi. Ayrıca, obez olmayan ve obez hastalarda hızlı göz hareketi (REM) AHİ ortalama skorları 4.6 ve 17.2 idi ve gruplar arasında istatistiksel olarak anlamlı bir fark mevcuttu. Ortalama en düşük oksijen doygunluğu açısından gruplar arasında istatistiksel olarak anlamlı bir fark vardı ve doygunluk obez grupta %75.5 iken, obez olmayan grupta %88 idi. Obez gruptaki REM bağımlı OUAS’lı hasta sayısı obez olmayan gruptan istatistiksel olarak anlamlı düzeyde daha yüksekti. Sonuç: Bu çalışmada, obezitenin, kısmi olarak yumuşak damak ve orofarenks seviyesinde havayolunun anlamlı derecede daralmasına neden olarak, OUAS şiddetini arttırdığı ortaya konmuştur. Ek olarak, çalışmamızda, supin pozisyon bağımlı OUAS ve REM bağımlı OUAS’ın obez hasta grubunda anlamlı olarak daha yüksek düzeyde olduğu ortaya konmuştur.

Anahtar Kelimeler:

Obezite, obstrüktif uyku apne sendromu

Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome

Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data. Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2) and non-obese patient groups (n=32; BMI Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had an average score of Class II, with a statistically significant intergroup difference. In Muller's maneuver, the levels of obstruction in both the soft palate and oropharynx were higher in the obese patients with a statistically significant difference between two groups. When polysomnography results were examined, the average apnea-hypopnea index (AHI) score was determined to be 22.5 in the obese and 6.4 in the non-obese groups, respectively. Furthermore, average scores of rapid eye movement (REM) AHI in the non-obese and obese patients were 4.6 and 17.2 with a statistically significant difference between the groups. The average lowest oxygen saturation was 75.5% in the obese and 88% in the non-obese group, which represented a statistically significant difference between groups. In the obese group, the number of patients with REM-dependent OSAS was higher than in the non-obese group which attained a level of statistical significance. Conclusion: Our study indicated that obesity increases the severity of OSAS, in part due to significant narrowing of the airway at the level of the soft palate and oropharynx. Additionally, our study has shown that the risk of supine position-dependent OSAS and especially REM-dependent OSAS were notably higher in obese patients.

Keywords:

Obesity, obstructive sleep apnea syndrome,

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Please cite this article as: Ünlü M, ‹riz A, Do¤an BA, Kayalı Dinç AS, Dursun E, Eryılmaz A, Acar A. Relationship between obesity with symptoms
and findings of obstructive sleep apnea syndrome. J Med Updates 2014;4(1):11-15.