SLEEP - Daytime Sleepiness in Obesity: Mechanisms Beyond Obstructive Sleep Apnea

VOLUME 35, ISSUE 05

DAYTIME SLEEPINESS IN OBESITY: MECHANISMS BEYOND OSA
Daytime Sleepiness in Obesity: Mechanisms Beyond Obstructive Sleep Apnea—A Review

http://dx.doi.org/10.5665/sleep.1812

Lori A. Panossian, MD; Sigrid C. Veasey, MD

Center for Sleep and Circadian Neurobiology and Department of Medicine, Sleep Division, University of Pennsylvania, Philadelphia, PA

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Increasing numbers of overweight children and adults are presenting to sleep medicine clinics for evaluation and treatment of sleepiness. Sleepiness negatively affects quality of life, mental health, productivity, and safety. Thus, it is essential to comprehensively address all potential causes of sleepiness. While many obese individuals presenting with hypersomnolence will be diagnosed with obstructive sleep apnea and their sleepiness will improve with effective therapy for sleep apnea, a significant proportion of patients will continue to have hypersomnolence. Clinical studies demonstrate that obesity without sleep apnea is also associated with a higher prevalence of hypersomnolence and that bariatric surgery can markedly improve hypersomnolence before resolution of obstructive sleep apnea. High fat diet in both humans and animals is associated with hypersomnolence. This review critically examines the relationships between sleepiness, feeding, obesity, and sleep apnea and then discusses the hormonal, metabolic, and inflammatory mechanisms potentially contributing to hypersomnolence in obesity, independent of sleep apnea and other established causes of excessive daytime sleepiness.

Citation:

Panossian LA; Veasey SC. Daytime sleepiness in obesity: mechanisms beyond obstructive sleep apnea—a review. SLEEP 2012;35(5):605-615.

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