TY - JOUR
T1 - Weight loss from lifestyle interventions and severity of sleep apnoea
T2 - a systematic review and meta-analysis
AU - Mitchell, Lana
AU - Davidson, Zoe Elise
AU - Bonham, Maxine Penelope
AU - O'Driscoll, Denise Marie
AU - Hamilton, Garun Stuart
AU - Truby, Helen
PY - 2014/10/1
Y1 - 2014/10/1
N2 - BACKGROUND: Excess body weight is a risk factor for obstructive sleep apnoea (OSA). The aim of the systematic review was to establish whether weight loss via lifestyle interventions such as diet and exercise are useful in the treatment of OSA.METHODS: A literature search was conducted between 1980 and February 2012. Systematic reviews and randomised controlled trials (RCTs) with participants who had OSA, were overweight or obese, and who had undergone lifestyle interventions with the aim of improving sleep apnoea were included. Meta analyses were conducted for a subset of RCTs with appropriate data.RESULTS: Two systematic reviews and eight RCTs were included. Meta-analyses were conducted for four RCTs comparing intensive lifestyle interventions to a control. The overall weighted mean differences for weight change, change in apnoea -hypopnoea index (AHI) and change in oxygen desaturation index of ≥4% were as follows: -13.76 kg (95% confidence interval (CI) -19.21, --8.32), -16.09 (95% CI -25.64, -6.54) and -14.18 (95% CI -24.23, -4.13), respectively. Although high heterogeneity within the meta analyses, all studies favoured the interventions. Long-term follow-up data from three RCTs suggest that improvements in weight and AHI are maintained for up to 60 months.CONCLUSIONS: Intensive lifestyle interventions are effective in the treatment of OSA, resulting in significant weight loss and a reduction in sleep apnoea severity. Weight loss via intensive lifestyle interventions could be encouraged as a treatment for mild to moderate OSA.
AB - BACKGROUND: Excess body weight is a risk factor for obstructive sleep apnoea (OSA). The aim of the systematic review was to establish whether weight loss via lifestyle interventions such as diet and exercise are useful in the treatment of OSA.METHODS: A literature search was conducted between 1980 and February 2012. Systematic reviews and randomised controlled trials (RCTs) with participants who had OSA, were overweight or obese, and who had undergone lifestyle interventions with the aim of improving sleep apnoea were included. Meta analyses were conducted for a subset of RCTs with appropriate data.RESULTS: Two systematic reviews and eight RCTs were included. Meta-analyses were conducted for four RCTs comparing intensive lifestyle interventions to a control. The overall weighted mean differences for weight change, change in apnoea -hypopnoea index (AHI) and change in oxygen desaturation index of ≥4% were as follows: -13.76 kg (95% confidence interval (CI) -19.21, --8.32), -16.09 (95% CI -25.64, -6.54) and -14.18 (95% CI -24.23, -4.13), respectively. Although high heterogeneity within the meta analyses, all studies favoured the interventions. Long-term follow-up data from three RCTs suggest that improvements in weight and AHI are maintained for up to 60 months.CONCLUSIONS: Intensive lifestyle interventions are effective in the treatment of OSA, resulting in significant weight loss and a reduction in sleep apnoea severity. Weight loss via intensive lifestyle interventions could be encouraged as a treatment for mild to moderate OSA.
KW - Lifestyle intervention
KW - Obstructive sleep apnoea
KW - Systematic review
KW - Treatment
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=84922558605&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2014.05.012
DO - 10.1016/j.sleep.2014.05.012
M3 - Article
C2 - 25192671
VL - 15
SP - 1173
EP - 1183
JO - Sleep Medicine
JF - Sleep Medicine
SN - 1389-9457
IS - 10
ER -