Long-Term Lift for Sleep Apnea Sufferers

Obstructive sleep apnea improves long term with weight loss through diet and exercise

(RxWiki News) Obesity can worsen obstructive sleep apnea. But if someone with this disorder learns how to eat right, exercise and lose weight, will it actually make a difference in the long run?

The findings of a recent study say yes.

Researchers followed up with participants in a study four years earlier. The original study involved a weight loss, diet and exercise counseling program for individuals with obstructive sleep apnea.

Even four years after that study ended, the participants who received counseling weighed less and had improved sleep apnea symptoms.

"Lose weight to help reduce sleep apnea."

The study, led by Henri Tuomilehto, MD, PhD, of the Oivauni Sleep Clinic in Kuopio, Finland, looked at the health of participants four years after they had participated in a one-year clinical research trial related to obstructive sleep apnea.

In the original study, 81 obese adults who had mild obstructive sleep apnea were randomly assigned to one of two groups.

One group spent a year receiving counseling on a healthy diet and physical activity. They also participated for three months in an intensive weight reduction program with a very low calorie diet.

The other group received three general counseling sessions related to diet and exercise.

At the end of the year during that earlier study, the group with the intensive counseling and weight loss program had lost weight and had improved sleep apnea symptoms.

For this study, Dr. Tuomilehto and colleagues followed up with 57 of the original participants four years later. During the time that had passed, none of the participants had received any counseling related to the original study.

The researchers assessed these participants' obstructive sleep apnea symptoms and their weight.

Those who had been in the group receiving intensive counseling had lost an average of 12 pounds, or 5.5 percent of their original weight.

Those who only received the three general sessions and nothing more had gained an average 1.3 pounds.

There was also a difference in sleep apnea symptoms between the two groups. Those in the intervention group (counseling and weight loss) had a lower apnea-hypopnea index than those in the control group.

The apnea-hypopnea index is a measure of how many times a person stops breathing for at least ten seconds while asleep. A score of 5-15 is generally diagnosed as mild sleep apnea while 15-30 is considered moderate, and more than 30 is considered severe.

Four years after the original study, the group who had received the intensive counseling had an apnea-hypopnea index number an average 0.8 points lower than they had when the original study began.

Meanwhile, those who did not receive long-term counseling on diet and exercise had an apnea-hypopnea index number 5 points higher, on average, than when the original study had begun.

The obstructive sleep apnea had worsened from mild to moderate in six of the participants in the intensive counseling group and in 12 of the participants in the control group (those who received only three counseling sessions).

Also, two participants in the control group developed severe obstructive sleep apnea.

Overall, the researchers reported that the individuals who had received counseling on diet, exercise and weight loss experienced a 61 percent improvement in their obstructive sleep apnea.

The researchers said their study shows the importance of weight loss to managing obstructive sleep apnea, something William Kohler, MD, a dailyRx expert, agrees with.

"This research shows that even a small amount of weight loss has a big impact on long term apnea improvement," said Dr. Kohler, the director of the Florida Sleep Institute in Spring Hill, Florida.

"The bottom line that we need to emphasize the need for healthy lifestyles, including weight loss, and we need to educate patients on the significance of weight loss," he said.

Dr. Kohler added, however, that other factors can cause sleep apnea too and should not be overlooked.

"Even though being overweight is a significant contributing factor to sleep apnea, there are many other causes, so we cannot neglect the skinny child who has big tonsils," Dr. Kohler said. "Anything that will cause narrowing of the posterior pharynx is a potential contributor factor to sleep apnea."

The study was published as a letter April 15 in the journal JAMA Internal Medicine.

The research was funded by the Hospital District of Northern Savo in Finland, Kuopio University Hospital, the Juho Vainio Foundation, the Yrjö Jahnsson Foundation, the Paulo Foundation, the Finnish Cultural Foundation, the Finnish Research Foundation of Otology, the Finnish Medical Foundation, the Respiratory Foundation and the Finnish Anti-Tuberculosis Foundation. The authors reported no conflicts of interest.

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Review Date: 
April 18, 2013