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Obesity, Dyslipidemia, and Sleep DisordersObesity, Dyslipidemia, and Sleep Disorders: Complexity Requires Complementary Analysis FREE TO VIEW

Daniel N. Polesel, Msc; Karen T. Nozoe; Diego V. L. Decleva, Msc; Sergio Tufik, MD, PhD; Monica L. Andersen, PhD
Author and Funding Information

From Departamento de Psicobiologia, Universidade Federal de São Paulo.

Correspondence to: Monica L. Andersen, PhD, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, Brazil, CEP 04024-002; e-mail: ml.andersen12@gmail.com.


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(4):1187-1188. doi:10.1378/chest.12-2648
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Published online
To the Editor:

We read with great interest the recent article by Toyama et al1 in CHEST (March 2013), which dealt with the association between sleep apnea, sleep duration, and serum lipid profile. First, we would like to congratulate the authors on carrying out an important study of dyslipidemia and sleep disturbances and their recognition of the importance of these conditions, given their significant global prevalence. Today’s modern lifestyle can cause several health concerns, resulting from sedentarism, inadequate eating habits, and sleep deprivation, thus constituting a global public health problem.2 However, we believe some additional considerations should be mentioned.

Despite the good experimental design, the distribution of individuals among the different professional fields was not clear, nor were their nutritional profiles. Grouping of individuals by job sector (eg, administrative/operational) could indicate the existence of risk factors to the health of employees, because of differences in the intensity of physical activity required for the work. Physical exercise and healthy eating habits directly improve quality of life in patients with dyslipidemia.3 Although the authors clearly reported the limitations of the study, we suggest the use of questionnaires to relate levels of physical exercise and eating habits to the disease and to control for the influence of these factors. Similarly, the observation of biochemical parameters could provide relevant results, because obstructive sleep apnea (OSA) is a precursor of various metabolic disorders, among other conditions. The main biochemical markers altered in these conditions are leptin, cytokines, interleukins, tumor necrosis factors, and C-reactive protein. These markers are related to obesity, inflammatory responses, hypertension, and apnea.4,5

In addition, complete polysomnography can provide valuable data beyond those provided by actigraphy and questionnaires. This evaluation permits the quantification of sleep efficiency and architecture, which can help elucidate the effects of disease on sleep. Moreover, a study to verify the relation between OSA and dyslipidemia should be carried out in patients undergoing treatment with continuous positive airway pressure. The use of this clinical intervention enables evaluation of the impact of treatment of OSA on dyslipidemia. In conclusion, we recognize the importance of this study, which provides a thorough look at the consequences of global problems such as obesity and sleep disorders, because the study was performed in overachievers, in whom these global problems mainly occur.

References

Toyama Y, Chin K, Chihara Y, et al. Association between sleep apnea, sleep duration, and serum lipid profile in an urban, male, working population in Japan. Chest. 2013;143(3):720-728. [CrossRef] [PubMed]
 
Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010;137(3):711-719. [CrossRef] [PubMed]
 
Varady KA, Jones PJ. Combination diet and exercise interventions for the treatment of dyslipidemia: an effective preliminary strategy to lower cholesterol levels? J Nutr. 2005;135(8):1829-1835. [PubMed]
 
Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6(10):772-783. [CrossRef] [PubMed]
 
Malli F, Papaioannou AI, Gourgoulianis KI, Daniil Z. The role of leptin in the respiratory system: an overview. Respir Res. 2010;11:152. [CrossRef] [PubMed]
 

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References

Toyama Y, Chin K, Chihara Y, et al. Association between sleep apnea, sleep duration, and serum lipid profile in an urban, male, working population in Japan. Chest. 2013;143(3):720-728. [CrossRef] [PubMed]
 
Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010;137(3):711-719. [CrossRef] [PubMed]
 
Varady KA, Jones PJ. Combination diet and exercise interventions for the treatment of dyslipidemia: an effective preliminary strategy to lower cholesterol levels? J Nutr. 2005;135(8):1829-1835. [PubMed]
 
Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6(10):772-783. [CrossRef] [PubMed]
 
Malli F, Papaioannou AI, Gourgoulianis KI, Daniil Z. The role of leptin in the respiratory system: an overview. Respir Res. 2010;11:152. [CrossRef] [PubMed]
 
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