A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study.

Full Abstract

BACKGROUND: The belief that weight loss improves obstructive sleep apnea (OSA) has limited empirical support. The purpose of this 4-center study was to assess the effects of weight loss on OSA over a 1-year period. METHODS: The study included 264 participants with type 2 diabetes and a mean (SD) age of 61.2 (6.5) years, weight of 102.4 (18.3) kg, body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) of 36.7 (5.7), and an apnea-hypopnea index (AHI) of 23.2 (16.5) events per hour. The participants were randomly assigned to either a behavioral weight loss program developed specifically for obese patients with type 2 diabetes (intensive lifestyle intervention [ILI]) or 3 group sessions related to effective diabetes management (diabetes support and education [DSE]). RESULTS: The ILI participants lost more weight at 1 year than did DSE participants (10.8 kg vs 0.6 kg; P < .001). Relative to the DSE group, the ILI intervention was associated with an adjusted (SE) decrease in AHI of 9.7 (2.0) events per hour (P < .001). At 1 year, more than 3 times as many participants in the ILI group than in the DSE group had total remission of their OSA, and the prevalence of severe OSA among ILI participants was half that of the DSE group. Initial AHI and weight loss were the strongest predictors of changes in AHI at 1 year (P < .01). Participants with a weight loss of 10 kg or more had the greatest reductions in AHI. CONCLUSIONS: Physicians and their patients can expect that weight loss will result in significant and clinically relevant improvements in OSA among obese patients with type 2 diabetes. Trial Registration clinicaltrials.gov Identifier: NCT00194259.

Author information

Author/s: Foster, Gary D (GD); Borradaile, Kelley E (KE); Sanders, Mark H (MH); Millman, Richard (R); Zammit, Gary (G); Newman, Anne B (AB); Wadden, Thomas A (TA); Kelley, David (D); Wing, Rena R (RR); Pi-Sunyer, F Xavier (FX); Reboussin, David (D); Kuna, Samuel T (ST); Sleep AHEAD Research Group of Look AHEAD Research Group;

Affiliation: Center for Obesity Research and Education, Temple University, 3223 N Broad St, Ste 175, Philadelphia, PA 19140, USA. gfoster(-atsign-)temple.edu

Grants: DK56992 (Agency:NIDDK NIH HHS) ; DK57002 (Agency:NIDDK NIH HHS) ; DK57135 (Agency:NIDDK NIH HHS) ; DK57178 (Agency:NIDDK NIH HHS) ; HL070301 (Agency:NHLBI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural

Journal: Archives of internal medicine (Arch Intern Med), published in United States. (Language: eng)

Reference: 2009-Sep; vol 169 (issue 17) : pp 1619-26

Dates: Created 2009/09/29; Completed 2009/10/15;

PMID: 19786682, status: MEDLINE (last retrieval date: 10/15/2009, IMS Date: )

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