Kim Beomsoo, Choi Ji Ho
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
J Rhinol. 2023 Mar;30(1):1-5. doi: 10.18787/jr.2023.00010. Epub 2023 Mar 30.
Obstructive sleep apnea (OSA) is a relatively common sleep disorder characterized by repetitive narrowing or obstruction of the upper airway, including the nasal cavity, pharynx, and larynx, during sleep. OSA can cause a variety of symptoms and/or complications, such as excessive daytime sleepiness, reduced concentration, hypertension, type II diabetes, and stroke. Accordingly, an accurate diagnosis and appropriate treatments are required for OSA. Obesity is an important risk factor for OSA and is characterized by the abnormal accumulation of fat in the body, including the upper airway. When the body weight increases, adipose tissue accumulates in the pharynx, which can narrow the diameter of the upper airway and lead to dysfunction of the pharynx dilator muscles. These changes caused by weight gain can cause or exacerbate OSA. Various therapeutic options exist for patients with overweight or obesity, including diet, behavioral modifications, exercise, pharmacological treatments, and surgical procedures. Of these, diet, behavioral modifications, and exercise constitute the first-line management for obesity. However, their results are relatively unsatisfactory, and pharmacotherapy and bariatric surgery are generally implemented in obese patients with OSA. Therefore, the purpose of this paper is to review pharmacological and surgical management strategies for obesity that are currently commonly used in overweight or obese adult patients with OSA.
阻塞性睡眠呼吸暂停（OSA）是一种相对常见的睡眠障碍，其特征是在睡眠期间上呼吸道（包括鼻腔、咽部和喉部）反复变窄或阻塞。OSA可导致多种症状和/或并发症，如白天过度嗜睡、注意力不集中、高血压、2型糖尿病和中风。因此，OSA需要准确的诊断和适当的治疗。肥胖是OSA的一个重要危险因素，其特征是身体（包括上呼吸道）脂肪异常堆积。体重增加时，脂肪组织在咽部堆积，可使上呼吸道直径变窄，并导致咽部扩张肌功能障碍。体重增加引起的这些变化可导致或加重OSA。超重或肥胖患者有多种治疗选择，包括饮食、行为改变、运动、药物治疗和手术程序。其中，饮食、行为改变和运动构成肥胖的一线管理方法。然而，它们的效果相对不理想，药物治疗和减肥手术通常应用于患有OSA的肥胖患者。因此，本文的目的是综述目前超重或肥胖成年OSA患者常用的肥胖药物和手术管理策略。
