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Sleep Med. 2014 Mar;15(3):329-35. doi: 10.1016/j.sleep.2013.11.786. Epub 2014 Jan 31.

The impact of weight reduction in the prevention of the progression of obstructive sleep apnea: an explanatory analysis of a 5-year observational follow-up trial.

Author information

1
Oivauni Sleep Clinic, Kuopio, Finland; Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Finland. Electronic address: henri.tuomilehto@oivauni.fi.
2
Department of Otorhinolaryngology, Kuopio University Hospital, Finland.
3
Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Finland; Clinical Research Center, Kuopio University Hospital, Kuopio, Finland.
4
Department of Health Promotion and Chronic Diseases Prevention, National Institute for Health and Welfare, Helsinki, Finland.
5
Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, Finland.
6
Department of Respiratory Medicine, Kuopio University Hospital, Finland.
7
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Finland.
8
Center for Vascular Prevention, Danube-University Krems, Krems, Austria; South Ostrobothnia Central Hospital, Seinäjoki, Finland.
9
Clinical Research Center, Kuopio University Hospital, Kuopio, Finland; Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland.

Abstract

BACKGROUND:

Obstructive sleep apnea (OSA) is a chronic progressive disease, and it is well-documented that severe OSA is associated with an increased cardiovascular morbidity and mortality. Weight reduction has been shown to improve OSA; however, we need further evidence to determine if it may prevent the progression of OSA in the long term. The aim of our study was to assess the impact of weight change during a 5-year observational follow-up of an original 1-year randomized controlled trial.

METHODS:

The participants were divided into the two groups according to the weight change at 5-year follow-up using the 5% weight loss as a cutoff point, which was later referred to as the successful (n = 20) or unsuccessful groups (n = 27). The change in apnea-hypopnea index (AHI) was the main objective outcome variable.

RESULTS:

Fifty-seven patients participated in the 5-year follow-up. At 5 years from the baseline, the change in AHI between the groups was significant in the successful group (-3.5 [95% confidence interval {CI}, -6.1 to -0.9]) compared with the unsuccessful group (5.0 [95% CI, 2.0-8.5]) (P = .002). Successful weight reduction achieved an 80% reduction in the incidence of progression of OSA compared to the unsuccessful group (log-rank test, P = .016).

CONCLUSIONS:

A moderate but sustained weight reduction can prevent the progression of the disease or even cure mild OSA in obese patients.

KEYWORDS:

Follow-up; Long term; Obstructive sleep apnea; Prevention; Progression; Sleep-disordered breathing; Weight loss

PMID:
24560188
DOI:
10.1016/j.sleep.2013.11.786
[Indexed for MEDLINE]

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