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Case Reports
. 2015 Apr 15;11(5):575-80.
doi: 10.5664/jcsm.4708.

Bone loss in obesity and obstructive sleep apnea: a review of literature

Marlene Chakhtoura  1 , Mona Nasrallah  1 , Hassan Chami  2   3
Affiliations
Case Reports

Bone loss in obesity and obstructive sleep apnea: a review of literature

Marlene Chakhtoura et al. J Clin Sleep Med. .

Abstract

Introduction: Obstructive sleep apnea (OSA) is a common sleep-related respiratory disorder. It is associated with many endocrinopathies including hypogonadotropic hypogonadism, hypercortisolism, and glucose intolerance that may lead to bone loss with secondary osteoporosis.

Methods: We report the case of a 41-year-old man who presented with bilateral 9th rib fractures and was found to have obstructive sleep apnea and osteoporosis. We also present a literature review on this topic.

Results: OSA can lead to bone loss through various mechanisms. Some are shared with obesity, including hypogonadism, altered adrenergic tone, inflammation, oxidative stress, vitamin D deficiency and diabetes mellitus; others are specific to OSA, such as hypoxia and altered glucocorticoids regulation.

Conclusion: There are no guidelines on screening for osteoporosis in OSA. Further research is needed to assess the incidence of bone loss and fractures in OSA.

Keywords: bone loss; fracture; hypoxia; obesity; obstructive sleep apnea.

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Figures

Figure 1
Figure 1. Chest CT of the patients with red arrows pointing to the bilateral fractures of the 9th ribs at the mid-axilla.
Figure 2
Figure 2. Bone scan showing increase uptake at the level of the 9th ribs bilaterally.
See this image and copyright information in PMC

Comment in

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