TY - JOUR
T1 - A 12-month weight loss intervention in adults with obstructive sleep apnoea
T2 - is timing important? A step wedge randomised trial
AU - Truby, Helen
AU - Edwards, Bradley A.
AU - Day, Kaitlin
AU - O’Driscoll, Denise M.
AU - Young, Alan
AU - Ghazi, Ladan
AU - Bristow, Claire
AU - Roem, Kerryn
AU - Bonham, Maxine P.
AU - Murgia, Chiara
AU - Haines, Terry P.
AU - Hamilton, Garun S.
N1 - Funding Information:
This trial is an investigator-initiated trial. Air Liquide provided CPAP machines and support to participants at no cost and had no role in the trial design and protocol development. By contractual agreement, researchers at Monash University have responsibility and independence regarding data management, analysis and publication. BAE was supported by a Heart Foundation of Australia Future Leader Fellowship (101167). GSH has received equipment to support research from Resmed, Philips Respironics and Air Liquide Healthcare. All other authors declare an absence of funding.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background/Objectives: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. Methods: Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. Results: After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [−0.3 to 0.36], p = 0.86). Conclusions: The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.
AB - Background/Objectives: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. Methods: Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. Results: After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [−0.3 to 0.36], p = 0.86). Conclusions: The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.
UR - http://www.scopus.com/inward/record.url?scp=85135556266&partnerID=8YFLogxK
U2 - 10.1038/s41430-022-01184-5
DO - 10.1038/s41430-022-01184-5
M3 - Article
C2 - 35927505
AN - SCOPUS:85135556266
SN - 0954-3007
VL - 76
SP - 1762
EP - 1769
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
IS - 12
ER -