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From the Cardiovascular Neurophysiology Laboratory, Cardiovascular
Division, Department of Internal Medicine (K.N., P.J.H.v.d.B., R.L.C., V.K.S.)
and the Department of Neurology (M.E.D.), University of Iowa College of
Medicine, Iowa City.
Correspondence to Virend Somers, MD, PhD, Cardiovascular Division, Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. E-mail virend-somers{at}uiowa.edu
Background—Obese humans are reported
to have increased muscle sympathetic nerve activity (MSNA). Obstructive
sleep apnea (OSA) may also be accompanied by increased MSNA. Because
there is a high prevalence of OSA in obese humans, it is possible that
high MSNA reported in obese subjects may in fact reflect the presence
of OSA in these subjects. We tested the hypothesis that obesity, per
se, in the absence of OSA, is not accompanied by increased MSNA.
Methods and Results—We measured MSNA in 25 healthy normal-weight
subjects and 30 healthy sedentary obese subjects. All subjects were
screened by history and examination to exclude subjects with OSA or
hypertension. OSA was further excluded by overnight polysomnographic
studies. Despite careful screening, polysomnography revealed that 1 of
25 normal-weight subjects and 9 of 30 obese subjects had occult OSA
(P=0.015). MSNA was similar in normal-weight subjects
(41±3 bursts per 100 heartbeats) and obese subjects without sleep
apnea (42±3 bursts per 100 heartbeats, P=0.99). MSNA in
the 9 obese subjects with occult OSA was 61±8 bursts per 100
heartbeats, which was higher than MSNA in normal-weight subjects
without sleep apnea (P=0.02) and higher than MSNA in
obese subjects without sleep apnea (P=0.02).
Conclusions—Obesity alone, in the absence of OSA, is not
accompanied by increased sympathetic activity to muscle blood vessels.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Sympathetic Activity in Obese Subjects With and Without Obstructive Sleep Apnea
Key Words: obesity • sleep • nervous system, autonomic • nervous system, sympathetic
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