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Diet, exercise alone did not eliminate obstructive sleep apnea in obese patients
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A strict diet and exercise program may be beneficial for obese patients with mild to moderate sleep apnea, but it is unlikely that it will cure sleep apnea alone, new data suggest.
"Obesity is a major risk factor for obstructive sleep apnea, but few patients actually manage to lose weight, which necessitates the use for other costly therapies," Maree Barnes, MD, of the Institute for Breathing and Sleep at Austin Health Heidelberg in Australia, told Endocrine Today.
Barnes and colleagues examined the clinical outcomes of obstructive sleep apnea following a 16-week exercise and diet program that assessed sleep disordered breathing, cardiovascular risk factors and neurobehavioral function (n=12; mean age, 42.3 years).
All patients were heavy snorers, two had preexisting CV disease, seven were current smokers, six were previously diagnosed with hypertension and two had stable type 2 diabetes. On average, patients weighed 95.6 kg and had a BMI of 36.1, waist circumference of 117.3 cm and a neck circumference of 42 cm.
Patients lost about 13% of total body weight from baseline. Further, the researchers reported significant reductions in BMI, body fat percentage, abdominal girth and neck circumference.
In addition, patients had a 7% increase in maximal work-load achieved and a 20% increase in peak oxygen consumption — independent of weight-loss.
The researchers observed a significant association between weight loss and changes in apnea-hypopnea index (R=0.66; P=.04).
Sleep efficiency significantly improved from 74.7% to 84.1% (P=.02) and minimum oxygen saturation showed a trend toward improvement from 88.1% to 89.9%. Subjective daytime sleepiness also improved, with a trend toward improvement in sleep apnea symptoms and in depression. After four months, nine out of 10 patients stated their snoring had improved noticeably.
"This study has shown that with a weight loss program that is specifically designed for this group of patients, not only is weight loss achievable, but has significant benefits for sleep apnea, cardiovascular risk and daytime function outcomes," Barnes said.
The researchers concluded that "these preliminary results need confirmation with a larger randomized trial." - by Jennifer Southall
Barnes M. J Clin Sleep Med. 2009; 5:409-415.