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| Neck size a strong sleep apnoea clue |
24-Aug-2007 |
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By Bianca Nogrady
Insulin levels and neck circumference are the two strongest predictors of the risk of obstructive sleep apnoea, a leading obesity expert says.
Speaking at the recent Australian Doctor/HealthEdGP Summit on Diabetes, Obesity and Heart Disease in Sydney, Associate Professor John Dixon said a neck circumference of 43cm or more for men and women was a clear predictor of obstructive sleep apnoea.
In obese patients, symptoms were not a good predictor because almost all people who had a BMI of 35 or more snored when they were sleeping, said Professor Dixon, from the Centre for Obesity Research and Education at the Alfred Hospital in Melbourne.
Daytime sleepiness was not a useful indicator because this was common among obese patients anyway, Professor Dixon said.
Neck circumference was also a strong predictor of polycystic ovary syndrome, because women with a neck circumference of 43cm or more were highly likely to experience irregular menstruation, he said.
Insulin resistance was also a significant risk factor for obstructive sleep apnoea, particularly in obese patients — so much so that Professor Dixon suggested diabetes and sleep clinics should be co-located.
“If you have a chap who’s got a BMI of 35, who has diabetes, it is very unlikely that that person won’t have significant obstructive sleep apnoea,”he told Australian Doctor.
Obstructive sleep apnoea could be difficult to pick up without a costly sleep study, so measuring neck circumference above the thyroid cartilage of these high-risk patients was a good idea, Professor Dixon said.
Continuous positive airway pressure therapy for these patients could not only improve their sleep apnoea but might also improve their adherence to, and success with, lifestyle interventions such as exercise and diet, he said.
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