When obesity is not enough

The role of body weight in the diagnosis of obstructive sleep apnea (OSA) is well known although the mechanisms through which this occurs remain a subject of discussion. Our hospital employs routine screening for OSA in bariatric surgery candidates regardless of sleep complaints. Our aim was to compare morbidly obese patients (body mass index (BMI) ≥ 40kg/m2) with and without OSA regarding age, sleepiness (using the Epworth scale and considered positive if >12/24), smoking habits, snoring and medical comorbidities. Patients were screened with a type III cardio-respiratory polygraphy. Out of a total of 264 screened patients, 37 (14%) had a negative polygraphy, all women. We retrospectively compared this group with 38 women with moderate to severe sleep apnea. Significant differences between apnea and non apnea patients were respectively seen in age (p The fact that only women had negative studies confirms that there are significant gender related differences in the upper airway, fat distribution and respiratory stability in OSA. This gender difference decreases as age increases which might explain the difference in age between both groups. Metabolic syndrome was more prevalent in patients with OSA even though all were morbidly obese. Both groups had similar complaints of sleepiness evaluated by the Epworth scale. Metabolic syndrome in this group of women seems to play a role in OSA that is independent of BMI and those patients should be carefully screened for cormobidities and OSA independently of having symptoms. In morbidly obese women sleepiness was not related with the presence of OSA.