Long-Term Effect of Weight Loss on Obstructive Sleep Apnea Severity in Obese Patients with Type 2 Diabetes
| Autor: | Anne B. Newman, John M. Jakicic, Samuel T. Kuna, Thomas A. Wadden, Mark H. Sanders, Gary Zammit, Gary D. Foster, David M. Reboussin, Kelley E. Borradaile, Rena R. Wing, F. Xavier Pi-Sunyer, Richard P. Millman |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
business.industry Type 2 diabetes medicine.disease Obesity respiratory tract diseases law.invention Obstructive sleep apnea Apnea–hypopnea index Randomized controlled trial Weight loss law Physiology (medical) Internal medicine Diabetes mellitus medicine Physical therapy Neurology (clinical) medicine.symptom business Body mass index |
| Zdroj: | Sleep. 36:641-649 |
| ISSN: | 1550-9109 0161-8105 |
| DOI: | 10.5665/sleep.2618 |
| Popis: | STUDY OBJECTIVES To examine whether the initial benefit of weight loss on obstructive sleep apnea (OSA) severity at 1 year is maintained at 4 years. DESIGN Randomized controlled trial with follow-up at 1, 2, and 4 years. SETTING 4 Look AHEAD clinical centers. PARTICIPANTS Two hundred sixty-four obese adults with type 2 diabetes and OSA. INTERVENTIONS Intensive lifestyle intervention with a behavioral weight loss program or diabetes support and education. MEASUREMENTS Change in apnea-hypopnea index on polysomnogram. RESULTS The intensive lifestyle intervention group's mean weight loss was 10.7 ± 0.7 (standard error), 7.4 ± 0.7, and 5.2 ± 0.7 kg at 1, 2, and 4 years respectively, compared to a less than 1-kg weight loss for the control group at each time (P < 0.001). Apnea-hypopnea index difference between groups was 9.7 ± 2.0, 8.0 ± 2.0, and 7.7 ± 2.3 events/h at 1, 2 and 4 years respectively (P < 0.001). Change in apnea-hypopnea index over time was related to the amount of weight loss (P < 0.0001) and intervention, independent of weight loss (P = 0.001). Remission of OSA at 4 years was 5 times more common with intensive lifestyle intervention (20.7%) than diabetes support and education (3.6%). CONCLUSIONS Among obese adults with type 2 diabetes and OSA, intensive lifestyle intervention produced greater reductions in weight and apnea-hypopnea index over a 4 year period than did diabetes support and education. Beneficial effects of intensive lifestyle intervention on apneahypopnea index at 1 year persisted at 4 years, despite an almost 50% weight regain. Effect of intensive lifestyle intervention on apnea-hypopnea index was largely, but not entirely, due to weight loss. |
| Databáze: | OpenAIRE |
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