Weight Loss Helped Obese With Apnea Breathe Easier

Obesity related sleep apnea leads to health risks that may be best treated by weight loss

(RxWiki News) With obstructive sleep apnea, breathing pauses during sleep. The condition, which is tied to obesity, can lead to serious health problems. Weight loss, however, may lower the risk for some of these health problems.

About one in five adults in the US has obstructive sleep apnea, a condition in which airways become narrowed or partially blocked during sleep, causing breathing to stop momentarily. Apnea is linked to being overweight. If left untreated, sleep apnea can be life-threatening, possibly leading to heart attack, stroke, heart disease and high blood pressure.

Even modest weight loss may improve apnea, and a new study found that weight loss was the single most important way for obese sleep apnea patients to boost their cardiovascular health.

"Shed pounds to lower the risk of complications related to sleep apnea."

Julio Chirinos, MD, an assistant professor of medicine at the Perelman School of Medicine at the University of Pennsylvania, led a team of researchers who followed 181 obese patients with moderate-to-severe obstructive sleep apnea.

These participants also had high C-reactive protein (CRP) levels. CRP is a protein measured in the blood that can be a sign of inflammation, or swelling, in the body associated with heart disease.

Dr. Chirinos assigned individuals to receive weight loss therapy, CPAP (continuous positive airway pressure) therapy or both CPAP and weight loss therapy.

In CPAP treatment, a sleep apnea patient wears a device while sleeping that helps air pass through the throat, reducing snoring and pauses in breathing.

After 24 weeks, the researchers saw that weight loss alone had the greatest impact on cardiovascular risks. Weight loss significantly lowered CRP, high blood pressure, high triglycerides (fats in the blood) and insulin resistance (a sign of diabetes).

Those assigned to combined interventions also had reductions in CRP levels, insulin resistance and triglycerides.

All three groups experienced lower blood pressure, but the CPAP group alone had no reduction in other risk factors.

CPAP combined with weight loss did provide an incremental reduction of insulin resistance, triglycerides and blood pressure, but the combination did not reduce CRP levels more than any treatment alone.

"These data argue against an independent causal relationship between obstructive sleep apnea and these cardiovascular risk factors in this population and suggest that CPAP is not an effective therapy to reduce the burden of these particular risk factors,” said Dr. Chirinos in a press release. “These findings also indicate that weight loss therapy should be a central component of strategies to improve the cardiovascular risk factor profile of obese patients with OSA."

He concluded that further research is needed to determine how to best deliver effective weight loss programs to obese patients and how to identify patients who would most benefit from blood pressure reduction through CPAP.

This study was published June 12 in The New England Journal of Medicine.

The research was supported by grants from the National Heart, Lung and Blood Institute.

One author reported receiving fees for serving on advisory boards for Novo Nordisk, Nutrisystem and Orexigen, consulting fees from Boehringer Ingelheim, and grant support from Weight Watchers, Novo Nordisk and Nutrisystem. Another author reported receiving fees for serving on advisory boards for ConAgra Foods, Tate and Lyle, and UnitedHealth Group, and reports being an employee of Weight Watchers.

Review Date: 
June 11, 2014