Abstract
Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea–hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea–hypopnea index (−2.83/h; 95% CI: −4.24, −1.41), total cholesterol (−0.12 mmol/L; 95% CI: −0.22, −0.01), triglycerides (−0.24 mmol/L; 95% CI: −0.46, −0.02), fasting insulin (−7.3 pmol/L; 95% CI: −11.5, −3.1), systolic (−1.86 mmHg; 95% CI: −3.57, −0.15) and diastolic blood pressure (−2.07 mmHg; 95% CI: −3.79, −0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.
Highlights
Obstructive sleep apnea (OSA) is a recognized cardio-metabolic disorder affecting 53%of the middle-to-older age general population, and 36% of OSA subjects having exclusive positional sleep apnea can be treated with positional therapy [1,2]
Recent results from the Sleep AHEAD Study confirmed that individuals with OSA and type 2 diabetes mellitus receiving intensive lifestyle intervention for weight loss had reduced OSA severity, related to changes in body weight, baseline apnea–hypopnea index (AHI) and intervention independent of weight change at 10 years [8]
Differentiated lifestyle interventions were applied in OSA individuals [13,14,15,16,17], until now there is no consistent finding that directly translates the effectiveness of lifestyle modification, expressed as body mass index (BMI) reduction, to changes in cardio-metabolic risk factors
Summary
Obstructive sleep apnea (OSA) is a recognized cardio-metabolic disorder affecting 53%of the middle-to-older age general population, and 36% of OSA subjects having exclusive positional sleep apnea can be treated with positional therapy [1,2]. It has been shown that the Mediterranean diet improves OSA regardless of CPAP use and weight loss, whereas body-mass reduction itself improves OSA severity and symptoms [7]. Recent results from the Sleep AHEAD Study confirmed that individuals with OSA and type 2 diabetes mellitus receiving intensive lifestyle intervention for weight loss had reduced OSA severity, related to changes in body weight, baseline AHI and intervention independent of weight change at 10 years [8]. Differentiated lifestyle interventions were applied in OSA individuals [13,14,15,16,17], until now there is no consistent finding that directly translates the effectiveness of lifestyle modification, expressed as body mass index (BMI) reduction, to changes in cardio-metabolic risk factors
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