Replies to post #252629 on Biotech Values

[Mufaso]

Yes- many examples out there why obesity causes obstructive sleep apnea (OSA) and it has been known for years and years. And it's a reciprocal relationship because OSA caused sleep deprivation can make people gain even more weight. The title of the article that started this thread was "New Holy Grail for Weight-Loss Drugs: Sleep Apnea". Personally I don't think it's "New" or a "Holy Grail" for weight loss drugs. (The Holy Grail IMO is tolerability as I have stated many times before because tolerability is what is needed for everyone that needs these meds to be able to stay on them.).

The article itself is a good one as it comments on the fact that Lilly ran a trial so the FDA would have data that proves what everyone already knew about the link between obesity and OSA . Just maybe if someone with OSA lost weight they might get more sleep, not need a CPAP machine and not be so cranky during the day. The article might have been even better if they pointed out that it might payoff for insurers to cover weight loss drugs because of all the other comorbidities (CVD, joint , back problems etc.) unless everybody on them goes blind (NAION see #msg-174701898). Sorry if I'm a bit testy as I didn't get much sleep last night.

If anyone cares to no more about why being overweight causes OSA and vice versa, here is a link to an article and quote from a 2008 ADA publication:

Numerous studies have shown the development or worsening of OSA with increasing weight, as opposed to substantial improvement with weight reduction. There are several mechanisms responsible for the increased risk of OSA with obesity. These include reduced pharyngeal lumen size due to fatty tissue within the airway or in its lateral walls, decreased upper airway muscle protective force due to fatty deposits in the muscle, and reduced upper airway size secondary to mass effect of the large abdomen on the chest wall and tracheal traction. These mechanisms emphasize the great importance of fat accumulated in the abdomen and neck regions compared with the peripheral one. It is the abdomen much more than the thighs that affect the upper airway size and function. Hence, obesity is associated with increased upper airway collapsibility (even in nonapneic subjects), with dramatic improvement after weight reduction. Conversely, OSA may itself predispose individuals to worsening obesity because of sleep deprivation, daytime somnolence, and disrupted metabolism. OSA is associated with increased sympathetic activation, sleep fragmentation, ineffective sleep, and insulin resistance, potentially leading to diabetes and aggravation of obesity. Furthermore, OSA may be associated with changes in leptin, ghrelin, and orexin levels; increased appetite and caloric intake; and again exacerbating obesity. Thus, it appears that obesity and OSA form a vicious cycle where each results in worsening of the other.

https://diabetesjournals.org/care/article/31/Supplement_2/S303/24789/Abdominal-Fat-and-Sleep-ApneaThe-chicken-or-the