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Clinical Guidelines: Vincenza Snow, Patricia Barry, Nick Fitterman, Amir Qaseem, Kevin Weiss for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians Ann Intern Med 2005; 142: 525-531 [Abstract] [Full text] [PDF]

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Treatment of Sleep Disorders May Be Essential in Some Patients with Obesity

Raymond E. Bourey   (12 April 2005)

Treatment of Sleep Disorders May Be Essential in Some Patients with Obesity 12 April 2005
Raymond E. Bourey, MD Regional Center for Sleep Medicine Send rapid response to journal: Re: Treatment of Sleep Disorders May Be Essential in Some Patients with Obesity sleepmed{at}buckeye-express.com Raymond E. Bourey	As an endocrinologist who is also board-certified and working full- time in sleep medicine, I have long observed that many obese patients who are unable to lose weight with efforts at diet and exercise suffer from the complications of sleep apnea and/or inadequate sleep. A growing body of clinical and basic research supports a relationship between sleep disorders, weight gain, and insulin-resistance. Beyond the complex hormonal and physiological basis for the this relationship, it is reasonable to simply assume that patients who suffer the decreased mental alertness of sleep deprivation will have trouble fighting strong, natural pressures toward sloth and gluttony. Before consideration of drugs, many of which can further compromise sleep quality, and surgical procedures and their attendant complications, I would urge clinicians to simply screen for sleep disturbances. Does the patient snore? Do they have insufficient time for sleep? Morbidly obese patients have such a high incidence of sleep apnea, that many surgical programs for obesity require pre-operative sleep studies. A sleep evaluation and appropriate treatment for a sleep disorder may be sufficient to provide the physiological "boost" needed for a successful program of diet and exercise which in turn will avoid the complexity, expense, and dangers of drugs and surgical procedures. Raymond E. Bourey, MD, FACP, FACE, DABSM Clinical Ass't. Professor of Medicine Medical College of Ohio Sleep Medicine and Metabolism Medical Director The Regional Center for Sleep Medicine 4041 West Sylvania Ave., Ste 202 Toledo, OH 43623 USA 1 419 292-1616 ph 1 419 472-2193 FAX Conflict of Interest: None declared