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Weight Loss Alleviates Sleep Apnea in Obese Men

Posted: Sunday, January 03, 2010

Dramatic weight loss proves to be an effective method for improving moderate-to-severe sleep apnea in obese men, with the greatest benefits seen in men with severe sleep apnea, according to a study.

"Our findings suggest that weight loss may be an effective treatment strategy for sleep apnea in obese men," said Kari Johansson, MD, PhD, Karolinska Institute, Stockholm, Sweden.

In this study, researchers examined if weight loss can improve or even help cure moderate and severe sleep apnea. The study included 63 obese men, with a body mass index (BMI) of 30 to 40, aged 30 to 65 years. The participants had moderate-to-severe sleep apnea, as measured by the Apnea-Hypopnea Index (AHI). They all received continuous positive airway pressure (CPAP) to alleviate their symptoms. They were randomly assigned to a treatment group, which underwent an intense weight-loss program, or to a control group for 9 weeks.

Results show that the weight-loss group lost a mean of 19 kg after 9 weeks and more than halved the number of apnea events. None of the treated patients had severe sleep apnea, half had only mild sleep apnea, and 1 in 6 was considered healthy. The researchers also noted that the effect of the weight-loss program was greatest in patients with severe sleep apnea.

To achieve significant weight loss, individuals in the treatment group received a very low calorie diet (VLCD), consisting of an initial energy input of 554 kcal/day for 7 weeks followed by a successive increase in caloric intake for up to 1,500 kcal per day for the next 2 weeks. The control group maintained their normal dietary habits during the 9-week study period, but was afterwards offered a VLCD program.

After the VLCD period, the participants also were invited to take part in a year-long behavioral change program to help them maintain their weight loss.

"We often use VLCD in the form of a low calorie powder as part of the treatment of obese patients with a serious comorbidity, such as sleep apnea," says Dr. Johansson. "The powder is mixed with water and replaces every meal of the day, which gives a rapid loss of weight. It's also a good way of boosting the patients' motivation."

The researchers note that the VLCD diet is not a general solution to weight problems, but something mainly to be used in the first phase of a long-term treatment program. To keep the weight off, patients need to work hard to improve their dietary and exercise habits, usually with the aid of a long-term behavior modification program. Drugs can also be used in the post-weight loss phase to further improve weight loss maintenance.

Source: Diabetes In Control: European Journal of Endocrinology (2009) In press DOI: 10.1530/EJE-09-0992