CHEST Guidelines-Apnea-in-the-Nonobese

Apnea-in-the-Nonobese_chest

Pdf Summary

In his correspondence, Dr. Robert G. Hooper discusses the complex relationship between obesity and obstructive sleep apnea (OSA), emphasizing the need for increased awareness of OSA in non-obese individuals. He comments on Dr. Joosten et al.'s review of OSA's link to obesity, noting that weight loss does not always resolve OSA in obese patients. Dr. Hooper points out that OSA persists even with an apnea-hypopnea index (AHI) below 5 in a significant number of patients post-weight loss, with 70% to 95% experiencing residual apnea. While some may assume weight as the sole cause, 41% of OSA patients in Dr. Hooper's practice were not obese at diagnosis. This underscores the need for ongoing patient awareness and periodic reassessment, regardless of treatment necessity.<br /><br />Dr. Hooper's observations suggest that OSA can occur independently of obesity, as severe cases exist among thin individuals, and mild cases among those with higher body mass indexes (BMIs). His data indicates that, even if all obese patients achieved a non-obese BMI, a vast majority (82.3% to 94.1%) would still experience persistent OSA due to other factors. He stresses that OSA and obesity are distinct, chronic conditions that constantly interact and exacerbate each other. Proper management requires acknowledging their interdependence and addressing them separately with long-term care strategies.<br /><br />Overall, Dr. Hooper calls for both medical professionals and patients to understand that while obesity often contributes to OSA, it is not the sole factor, and non-obese individuals can still be affected. Therefore, addressing OSA requires comprehensive management beyond just weight reduction.

Keywords

obstructive sleep apnea

OSA

obesity

weight loss

apnea-hypopnea index

non-obese individuals

patient awareness

chronic conditions

long-term care

comprehensive management