Weight loss resolved obstructive sleep apnea in obese patients with type 2 diabetes

Weight loss as a result of an intensive lifestyle intervention significantly improved obstructive sleep apnea among obese patients with type 2 diabetes, according to recent data from the Sleep AHEAD study.

“The greatest benefit was observed in men, in participants with more severe obstructive sleep apnea at baseline and in participants who lost the most weight,” the researchers wrote.

Researchers randomly assigned 264 participants with type 2 diabetes to a behavioral weight loss program (intensive lifestyle modification) or to three group sessions on diabetes support and education. Participants were a mean age of 61.2 years.

Compared with participants in the diabetes support and education group, participants in the intensive lifestyle intervention group had greater weight loss at year one (P<.001). In addition, more than three times as many participants in the intensive lifestyle intervention group had total remission of obstructive sleep apnea compared with participants in the diabetes support and education group. The prevalence of severe obstructive sleep apnea among the intervention group was half that of the diabetes support and education group.

Data further indicated that the intensive lifestyle intervention was associated with an adjusted decrease in apnea-hypopnea index of 9.7 events per hour (P<.001).

The researchers reported treatment interactions for sex (P<.02) and baseline apnea-hypopnea index (P<.001). The intensive lifestyle intervention was more effective in decreasing apnea-hypopnea index in men compared with women and in patients with higher baseline apnea-hypopnea index levels at baseline. Initial apnea-hypopnea index and weight loss were the strongest predictors for change after one year.

The researchers concluded: “These results should not be generalized to younger patients, to patients without type 2 diabetes or to patients with milder degrees of obstructive sleep apnea. Similarly designed randomized controlled trials are needed to assess the effects of weight loss on obstructive sleep apnea in these groups and should also explore the reasons for these improvements in obstructive sleep apnea.”

Foster GD. Arch Intern Med. 2009; 169:1619-1626.