The Impact of Obesity and Its Associated Sleep Disorders Either Alone or in Combination towards Syst

Aims: A major public health concern is both obesity and sleep disorders. In this research, in the Turkish adult population, the prevalence and effects of obesity and related sleep disorders were investigated.

Methodology: Data from a population-based research interviewer-administered questionnaire was analyzed in 5019 subjects with available body mass index (BMI) data (Turkish Adult Population Epidemiology of Sleep Disorders study: TAPES, original sample: 5521). Obesity was detected and graded as underweight by BMI in four classes (BMI<18 kg/m2), Standard (18 BMI<25 kg/m2), obese (BMI >30 kg/m2) and overweight (25 BMI<30 kg/m2). According to the International Restless Legs Syndrome Research Group criteria, insomnia was identified according to the DSM-IV criteria, habitual snoring and risk for sleep-related breathing disorders (SDB) using the Berlin questionnaire, excessive daytime sleepiness with the Epworth sleepiness scale score, and restless leg syndrome (RLS) according to symptoms.

Results: The rates of underweight, average, overweight, and obesity were 2.9%, 40.5%, 34.3%, and 22.3 percent, respectively. After adjustment for age, gender, smoking status, educational status and income levels, obesity was correlated with the increased risk of SDB (OR: 13.03, 95 percent CI: 9.91-17.14), RLSS: Obesity was more common in women, and in the middle age, divorced/widowed, lower education status, ex-smoker, low-income, and no daily exercise groups (OR: 1.43, 95 percent CI: 1.01-2.02). In the obese population, the risk of heart disease, hypertension, diabetes mellitus, and hospitalization in the past year was higher even after age, sex, smoking status, educational status, and income levels were changed [OR= 2.06 (1.50-2.82), OR= 3.45 (2.64-4.51), OR= 2.93 (2.05-4.16), and OR= 1.55 (1.22-1.98). In subjects who were overweight and obese and who had a high risk of SDB and subjects with obesity who had RLS, the risk of heart disease increased. The risk of diabetes mellitus increased in obese subjects who were at high risk for SDB or RLS.

Conclusion: High risk of systemic diseases has been associated with obesity and higher risk of systemic diseases such as heart disease and diabetes has been associated with obesity along with sleep disorders. Screening for sleep-related symptoms, if verified by prospective longitudinal research with objective measurements, may help to classify adults with obesity at high risk of heart disease and diabetes and to carry out preventive measures and better management of these populations.

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