Sleep apnea – a dangerous complication of obesity

At the online discussion Obesity and some related diseases Organized by the Department of Medical Examination and Treatment Management (Ministry of Health) on December 10, Dr. Phan Thanh Thuy, Respiratory Center, Bach Mai Hospital, said sleep apnea is a sleep disorder. The patient has episodes of complete apnea or reduced breathing for at least 10 seconds during sleep and repeats many times during the night.

This disorder is divided into 3 types including obstructive, central and mixed apnea. Among them, obstructive apnea is the most common, accounting for more than 80%.

The prevalence of sleep apnea in Vietnam is estimated to be 8.5% of adults, with more men than women. Groups of people with a higher incidence include overweight and obesity, cardiovascular disease, hypertension, asthma, COPD… Notably, 60-90% of apnea patients are overweight and obese.

“Sleep apnea increases with BMI (body mass index), meaning obesity is the most important risk for sleep apnea,” Dr. Thuy said, citing the rate of sleep apnea up to 50-98% in people with BMI over 40.

In overweight and obese people, excess fat surrounds the neck and upper respiratory tract, causing narrowing of the airways. This contributes to increased airway compression during sleep. In addition, fat accumulation in the chest and abdomen reduces lung capacity and increases oxygen demand, making the condition more serious.

“If not treated promptly, sleep apnea will cause many dangerous complications, such as myocardial infarction, heart failure, arrhythmia, stroke, hypertension, and stroke,” Dr. Thuy warned, adding that there are patients whose oxygen saturation drops below 50% at night, increasing the risk of sudden death.

Dr. Thuy said weight, sleep apnea and metabolism have a two-way relationship. Increased weight can increase sleep apnea episodes, specifically, a 10% increase in weight increases the risk of sleep apnea by 32%. At the same time, sleep apnea disrupts glucose metabolism, increases insulin resistance, easily leading to type 2 diabetes and weight regain.

A common symptom is snoring. This is the most common sign, patients have episodes of nocturnal apnea, wheezing, panting and at the end of the period of apnea. Snoring is loudest when lying on your back, decreases when lying on your side.

During the day, they are often tired, have difficulty concentrating at work, have memory loss, have mood changes, are easily irritable, and can fall asleep while working, even while driving. Patients may also have headaches when waking up, caused by reduced brain oxygen levels during the night.

Prof. Dr. Pham Manh Hung, President of the Southeast Asian Cardiology Federation, said that Vietnam is on the list of countries with the fastest increasing obesity rate in Southeast Asia. Statistics from the Institute of Nutrition also show that the rate of overweight and obesity among school-aged children 5 – 19 years old doubled in a decade from 8.5% in 2010 to 19% in 2020. Notably, the obesity rate among teenagers in Ho Chi Minh City has exceeded the 50% mark, Hanoi is over 41%.

“Obesity is a serious chronic disease related to more than 200 other diseases, including diabetes, cardiovascular disease, osteoarthritis, and sleep apnea,” Professor Hung emphasized, recommending good weight control will help reduce these complications.

Experts see weight loss as the preferred treatment option for overweight or obese patients with sleep apnea. Losing 10% of your weight helps reduce your sleep apnea index by 26%. Patients need to exercise at least 30 minutes a day and at least 3 days a week, while maintaining a scientific diet. In addition, patients will be given obesity treatment drugs or surgical intervention as needed.

“Obesity requires multidisciplinary treatment. Early and proactive dialogue between obese patients and medical professionals helps improve awareness and increase weight management effectiveness,” said Professor Hung.