Kopelman P G, Apps M C, Cope T, Ingram D A, Empey D W, Evans S J
Int J Obes. 1986;10(3):211-7.
A disorder of breathing during sleep with a fall in arterial oxygen saturation (%SaO2) and apnoea is reported in association with obesity. In obese women an increased severity of oxygen desaturation and the appearance of sleep apnoea is often seen after the menopause whereas the factors influencing sleep-breathing patterns in obese men are uncertain. We investigated this by studying respiration during sleep in 20 asymptomatic obese men (mean wt 125 kg, age range 18-59 y) and 20 control men of normal weight (mean wt 67 kg, age range 19-67 y). In the obese men the mean awake %SaO2 measured in the supine position was significantly less than controls (obese 95 +/- 0.4, controls 97 +/- 0.2, P less than 0.01) and a greater fall in %SaO2 occurred in this group during sleep (mean asleep %SaO2 obese 90.5 +/- 0.9, controls 96 +/- 0.2, P less than 0.01). In addition, the minimum asleep %SaO2 was significantly less in the obese (mean minimum %SaO2 obese 75 +/- 3, controls 93 +/- 0.9, P less than 0.001). Sleep apnoea was uncommon and infrequent in the controls but was seen in nine obese men and was frequent throughout the night in seven of them. In the obese group increasing age and increasing obesity were not significantly correlated with an increased severity of nocturnal oxygen desaturation. We conclude that disordered sleep-breathing with marked oxygen desaturation and apnoea is a common finding in extremely obese men of all ages and suggest that this results from the mechanical impedence of breathing due to abdominal adipose tissue combined with abnormal central respiratory control.
据报道，睡眠期间的呼吸障碍伴有动脉血氧饱和度（%SaO2）下降和呼吸暂停，与肥胖有关。在肥胖女性中，绝经后常常出现氧饱和度下降加重和睡眠呼吸暂停，而影响肥胖男性睡眠呼吸模式的因素尚不确定。我们通过研究20名无症状肥胖男性（平均体重125千克，年龄范围18 - 59岁）和20名正常体重对照男性（平均体重67千克，年龄范围19 - 67岁）的睡眠呼吸情况对此进行了调查。肥胖男性仰卧位时测得的清醒状态下平均%SaO2显著低于对照组（肥胖组95±0.4，对照组97±0.2，P<0.01），且该组在睡眠期间%SaO2下降幅度更大（肥胖组睡眠中平均%SaO2为90.5±0.9，对照组为96±0.2，P<0.01）。此外，肥胖组睡眠中最低%SaO2显著更低（肥胖组平均最低%SaO2为75±3，对照组为93±0.9，P<0.001）。睡眠呼吸暂停在对照组中不常见且不频繁，但在9名肥胖男性中出现，其中7人整夜频繁出现。在肥胖组中，年龄增长和肥胖程度增加与夜间氧饱和度下降严重程度增加无显著相关性。我们得出结论，伴有明显氧饱和度下降和呼吸暂停的睡眠呼吸障碍在各年龄段的极度肥胖男性中很常见，并认为这是由于腹部脂肪组织导致的呼吸机械性阻碍以及中枢呼吸控制异常所致。
