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.
