The Management of Obesity and Related Disorders

By Peter G. Kopelman | Go to book overview
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6

Obesity and respiratory complications

Tracey D Robinson and Ronald R Grunstein

Introduction

Obesity can impact significantly on lung function, with excess central fat deposition producing a restrictive pulmonary abnormality and increased work of breathing. As a result, respiratory complaints are common in subjects with obesity and conditions such as asthma are often overdiagnosed in obese patients. Obesity is also strongly linked to breathing disorders during sleep, such as sleep apnoea and nocturnal hypoventilation. Sleep-disordered breathing has a number of clinical consequences, including impaired daytime gas exchange and excess cardiovascular morbidity. The combination of obesity-induced reduced pulmonary function and sleep-disordered breathing can lead to progressive respiratory failure during sleep, finally resulting in awake hypercapnic respiratory failure (obesity-hypoventilation syndrome, OHS). OHS can occur without any intrinsic lung disease. Weight reduction can improve lung function, reduce respiratory symptoms and reduce the severity of sleep apnoea. However, long-term maintenance of weight loss is difficult to achieve. Treatment of sleep-breathing disorders has been advanced greatly by the use of positive airway pressure devices

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