"Sleep apnea, severe snoring, high blood pressure patients, effective treatment for obesity metabolic surgery"
Oct 01, 2024
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Lee Seong-bae, director of the Obesity Metabolic Surgery Center at Sejong Hospital in Incheon, said "Sleep apnea is usually treated in a non-surgical manner controlled by a positive pressure device, and since sleep apnea and obesity low-ventilation syndrome are usually caused by obesity and are accompanied by various complications such as high blood pressure, it is effective to fundamentally treat obesity through obesity metabolic surgery."
A typical symptom of obesity low-ventilation syndrome is severe snoring that seriously interferes with the sleep of the person who sleeps with it. It is also accompanied by sleep apnea. Sleep apnea is a condition in which the symptoms of stopping breathing for more than 10 seconds while sleeping are repeated. Usually, if you complain of apnea more than five times an hour, it is diagnosed as sleep apnea. Most of them are accompanied by a decrease in blood oxygen saturation.
In addition, it causes difficulty in breathing, chronic cough, dry mouth and mouth, daytime sleep, increased daytime fatigue, depression, cognitive impairment, and headache, which interfere with daily life.
Obesity low-ventilation syndrome and sleep apnea cause various complications. Repeated hypoxia causes inflammatory reactions and oxidative stress in the body, resulting in decreased heart rate and slowing of the sympathetic and parasympathetic nervous systems. Eventually, the risk of dementia, cardiovascular and cerebrovascular diseases, and metabolic diseases increases, and the mortality rate increases.
In particular, obstructive sleep apnea is one of the causes of secondary hypertension. It causes changes in the shape of the atrial heart, pressure load on the left ventricular wall, worsening the arrhythmia. It has been reported that patients with obstructive sleep apnea increase the risk of atrial fibrillation by four times, the risk of ventricular tachycardia by 3.4 times, and the risk of heart failure by 2.2 times compared to normal people. There are also studies showing that coronary calcification is significantly more observed in patients with obstructive sleep apnea.
Treatment of obesity low-ventilation syndrome and sleep apnea, which are accompanied by such serious complications, is essential.
The American Society of Sleep Medicine recommends 'positive pressure (CPAP)' as the standard treatment for sleep apnea. A positive pressure device consisting of a mask, respiratory tract, and body is a non-surgical treatment method that injects air into the respiratory tract of a sleeping patient to prevent airway stenosis.
However, it cannot cure the underlying disease of obesity. Obesity low-ventilation syndrome and sleep apnea are mostly improved by obesity treatment because positive pressure is only a device that assists breathing and is not related to obesity treatment.
The head of the center emphasizes that 'obesity metabolic surgery' is inevitable, especially in the case of high obesity.
The head of the center explained that "non-surgical treatment has little effect on highly obese patients" and that "only 1 in 1,000 highly obese patients in their 30s and 40s will lose weight on their own"."
Obesity metabolism surgery is largely divided into the intake-suppressing type 'gastric sleeve resection' and the absorption-suppressing type 'Louwai gastrectomy'.
Gastric sleeve resection reduces stomach volume to about 14% compared to before surgery by resecting the stomach in the shape of a banana. As the overall size of the stomach decreases, it is easy to feel full, and appetite and taste change due to changes in hormones. It also has the advantage of being able to leave the hospital two days later due to laparoscopic surgery. One year after surgery, the weight loss effect due to surgery ends as the stomach volume increases and is maintained to 30% of the preoperative stomach volume.
Luwai gastrostomy is a surgical procedure in which the upper part of the stomach is separated into a small pocket shape and the small intestine is connected in a Y-shape. It preserves pancreatic function and blocks blood sugar from rising by transferring the point at which food meets pancreatic fluid and bile fluid in the duodenum to the lower small intestine. It is a surgery with a very high rate of complete remission of type 2 diabetes (the symptoms and signs of the disease have decreased or disappeared). It is recommended for patients who receive insulin or take more than three types of diabetes drugs.
Both surgeries have the effect of losing 30 to 35% of weight compared to before surgery. When highly obese patients with diabetes undergo obesity metabolic surgery, their life expectancy increases by 9.3 years, and cancer incidence and cancer mortality decrease to 50% and 30%, respectively. Yo-yo phenomenon is also rare, allowing weight loss to be maintained for more than 15 years. The government also recognized its importance and applied health insurance to obesity metabolic surgery.
Lee Seong-bae, head of the center, said, "The purpose of obesity metabolic surgery is to alleviate various metabolic diseases such as type 2 diabetes, high blood pressure, hyperlipidemia, non-alcoholic fatty liver, and asthma and to prevent fatal diseases such as stroke and myocardial infarction." This is because it not only physically limits the volume of stomach, but also induces changes in hormones that reduce appetite and change appetite.'
"Patients with complications such as sleep apnea, severe snoring, and high blood pressure are advised not to suffer anymore, and to improve their quality of life by losing and controlling weight with professional medical staff and preventing future diseases."," he added.
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