Impact of a brief dietary self-monitoring intervention on weight change and CPAP adherence in patients with obstructive sleep apnea.
ABSTRACT OBJECTIVE: Weight loss can decrease the severity of obstructive sleep apnea (OSA) in many obese individuals; however, very few studies have investigated the effects of behavioral weight loss interventions for patients with OSA. The aims of this pilot study were to determine the feasibility and initial effects on weight and continuous positive airway pressure (CPAP) use of a brief minimal-contact self-monitoring-based weight loss intervention (SM). An additional aim was to investigate the association between weight loss and CPAP adherence. METHODS: Forty obese men and women diagnosed with mild or moderate OSA were randomized to either the SM or an attention-control (AC) condition. SM participants completed daily dietary logs for 6weeks. Participants were weighed at baseline, post-treatment (6weeks), and at a 6-week follow up. RESULTS: Recruitment and retention were good in this study and attrition rates did not differ significantly by group. Intent to treat repeated measures ANOVA indicated a main effect of time (but not group), such that both groups lost weight over time. Pearson r correlations between weight change and CPAP adherence indicated that among SM participants, 6-week weight loss was correlated with CPAP adherence at post-treatment and follow-up, such that SM participants with greater weight loss at 6weeks had greater CPAP adherence at 6 and 12weeks. CONCLUSION: This study provides initial support for the beneficial effects of a minimal-contact weight loss intervention for patients with obstructive sleep apnea and highlights a possible association between weight loss and CPAP adherence.
Revista Española de Geriatría y Gerontología 03/2014; DOI:10.1016/j.regg.2014.02.004
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ABSTRACT: Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients.Sleep 10/2014; DOI:10.5665/sleep.4186 · 5.06 Impact Factor
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ABSTRACT: Obesity has long been recognised as the most important reversible risk factor for obstructive sleep apnoea (OSA). Analyses from the Wisconsin Sleep Cohort Study suggest that 41% of adult OSA cases, including 58% of moderate-to-severe cases, are attributable to overweight or obesity.1 As such, weight loss has long been recommended as an ancillary treatment for OSA. Longitudinal analyses from the Sleep Heart Health Study support the notion that weight loss is associated with improvements in OSA severity.2 However, the beneficial impact of weight loss was much less than the adverse effect of the same amount of weight gain in that study suggesting that the relationship between obesity and OSA is more complex than can be explained by an acute (and reversible) unidirectional causal model. Given evidence that short sleep durations and poor quality sleep predict an increased rate of weight gain,3 ,4 many have postulated that OSA may itself predispose to obesity. Retrospective data indicate that those with recently diagnosed OSA are more likely to have had recent weight gain.5 These findings have been used to support the contention that OSA causes weight gain but of course, this may simply reflect the impact of weight gain on OSA risk. An association between OSA and elevated leptin levels, which fall with CPAP therapy, suggests that an effect of OSA on weight gain may be mediated by leptin resistance whereby improvements in leptin resistance with OSA treatment would produce weight loss.6 Uncontrolled studies have reported that initiation of CPAP therapy is associated with induction of mild weight loss.7 However, given that most patients are educated on the association between obesity and OSA at … [Full text of this article]Thorax 12/2014; 70(3). DOI:10.1136/thoraxjnl-2014-206484 · 8.56 Impact Factor