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Sleep. 2013 May 1;36(5):641-649A. doi: 10.5665/sleep.2618.

Long-term effect of weight loss on obstructive sleep apnea severity in obese patients with type 2 diabetes.

Author information

1
University of Pennsylvania, Philadelphia, PA, USA. skuna@mail.med.upenn.edu

Abstract

STUDY OBJECTIVES:

To examine whether the initial benefit of weight loss on obstructive sleep apnea (OSA) severity at 1 year is maintained at 4 years.

DESIGN:

Randomized controlled trial with follow-up at 1, 2, and 4 years.

SETTING:

4 Look AHEAD clinical centers.

PARTICIPANTS:

Two hundred sixty-four obese adults with type 2 diabetes and OSA.

INTERVENTIONS:

Intensive lifestyle intervention with a behavioral weight loss program or diabetes support and education.

MEASUREMENTS:

Change in apnea-hypopnea index on polysomnogram.

RESULTS:

The intensive lifestyle intervention group's mean weight loss was 10.7 ± 0.7 (standard error), 7.4 ± 0.7, and 5.2 ± 0.7 kg at 1, 2, and 4 years respectively, compared to a less than 1-kg weight loss for the control group at each time (P < 0.001). Apnea-hypopnea index difference between groups was 9.7 ± 2.0, 8.0 ± 2.0, and 7.7 ± 2.3 events/h at 1, 2 and 4 years respectively (P < 0.001). Change in apnea-hypopnea index over time was related to the amount of weight loss (P < 0.0001) and intervention, independent of weight loss (P = 0.001). Remission of OSA at 4 years was 5 times more common with intensive lifestyle intervention (20.7%) than diabetes support and education (3.6%).

CONCLUSIONS:

Among obese adults with type 2 diabetes and OSA, intensive lifestyle intervention produced greater reductions in weight and apnea-hypopnea index over a 4 year period than did diabetes support and education. Beneficial effects of intensive lifestyle intervention on apneahypopnea index at 1 year persisted at 4 years, despite an almost 50% weight regain. Effect of intensive lifestyle intervention on apnea-hypopnea index was largely, but not entirely, due to weight loss.

KEYWORDS:

Apnea-hypopnea index; polysomnogram

PMID:
23633746
PMCID:
PMC3624818
DOI:
10.5665/sleep.2618
[Indexed for MEDLINE]
Free PMC Article
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