Weight Loss, Lifestyle Interventions Improve Obstructive Sleep Apnea

Almudena Carneiro-Barrera, PhD

A study on sleep health found that interdisciplinary weight loss and lifestyle interventions resulted in clinically meaningful and sustainable improvements in obstructive sleep apnea (OSA) in adult Spanish males with moderate to severe OSA.

Investigators suggested that this approach could be considered as a central sleep strategy for the increasingly common sleep-discorded breathing condition.

Despite obesity being the leading cause of OSA - affecting up to 936 million adults in the general population – the implications of weight loss and lifestyle interventions on the condition remained unknown.

As such, investigators led by Almudena Carneiro-Barrera, PhD, of the University of Granada, Spain, sought to determine the effects of novel interdisciplinary weight loss and lifestyle intervention on OSA severity and comorbidities in Spanish adult men with moderate to severe OSA.

The team conducted the Interdisciplinary Weight Loss and Lifestyle Intervention (INTERAPNEA) trial, an 8-week trial that evaluated the effect of these potential sleep strategies and compared them to usual care for OSA.

Men aged 18-65 years with moderate to severe OSA who were receiving CPAP therapy and had a body mass index of 25 or greater were eligible for inclusion, with the sole inclusion of men being considered due to the higher incidence and prevalence of OSA in the population.

From April 1, 2019 to January 24, 2020, investigators performed recruitment, enrollment, and randomization of participants from 3 consecutive sets of 30-35 eligible participants.

Following enrollment, participants were randomized to receive either usual care or a weight loss and lifestyle intervention combined with usual care.

Lifestyle interventions involved nutritional behavior changes, aerobic exercise, sleep hygiene, and alcohol and tobacco cessation.

The primary endpoints were a change in the apnea-hypopnea index (AHI) from baseline to intervention endpoint and 6 months following intervention.

Overall, 89 men of Spanish ethnicity were enrolled in the trial with a mean age of 54 years, 40 of whom were randomized to the intervention group.

Investigators observed a greater decrease in AGI from the intervention group (51% reduction) when compared to the control group.

At 6 months after the intervention, reduction in AHI the intervention group was 57%.

Additionally, 18 of the 40 participants (45%) in the intervention group did not require CPAP therapy at the intervention endpoint compared to 6 participants (15%) in the control group.

By 6 months, 21 of 34 participants in the intervention group (61.8%) no longer required CPAP therapy, and 10 participants experienced complete remission of OSA.

“We found that reductions in BMI were significantly associated with changes in AHI over time,” the team wrote. “Adverse lifestyle behaviors, such as poor diet, low physical activity levels, smoking, and alcohol intake, have also been reported to be associated with OSA independent of body habitus.Thus, a combination of both weight loss and lifestyle changes may even resolve OSA in individuals with overweight or obesity.”

The study, "Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention

on Obstructive Sleep Apnea Severity," was published online in JAMA Network Open.