TY - JOUR
T1 - Effects of weight loss on obstructive sleep apnea severity ten-year results of the sleep AHEAD study
AU - the Sleep AHEAD Research Subgroup of the Look AHEAD Research Group
AU - Kuna, Samuel T.
AU - Reboussin, David M.
AU - Strotmeyer, Elsa S.
AU - Millman, Richard P.
AU - Zammit, Gary
AU - Walkup, Michael P.
AU - Wadden, Thomas A.
AU - Wing, Rena R.
AU - Xavier Pi-Sunyer, F.
AU - Spira, Adam P.
AU - Foster, Gary D.
AU - Freeman, Jon
AU - Patricio, Jennifer
AU - Sifferman, Andrea
AU - McGuckin, Brian
AU - Krauthamer-Ewing, Stephanie
AU - Jones-Parker, Mary
AU - Anastasi, Matthew
AU - Staley, Beth
AU - Roben, Liz
AU - Kearns, Marie
AU - Egan, Caitlin
AU - Wojtanowski, Alexis
AU - Cassim, Nida
AU - Darcey, Valerie
AU - Hin, Sakhena
AU - Vander Veur, Stephanie
AU - Strohl, Kingman P.
AU - Bliwise, Donald L.
AU - Resnick, Helaine E.
N1 - Funding Information:
A list of the Sleep AHEAD Research Subgroup of the Look AHEAD Research Group members may be found before the beginning of the REFERENCES. Supported by the NIH NHLBI grant HL070301 and National Institute of Diabetes and Digestive and Kidney Diseases grants DK60426, DK56992, and DK057135. Author Contributions: All authors were involved in the conception and design of the study, data collection, and data analysis and interpretation. All authors provided critical revision of the manuscript and approved the final version. Conception and design: S.T.K., D.M.R., R.P.M., G.Z., and G.D.F. Data collection: S.T.K., E.S.S., D.M.R., R.P.M., G.Z., R.R.W., F.X.P.-S., T.A.W., and G.D.F. Analysis and interpretation: S.T.K., D.M.R., M.P.W., and G.D.F. Drafting the manuscript for important intellectual content: S.T.K., G.D.F., D.M.R., M.P.W., T.A.W., and A.P.S.
Publisher Copyright:
Copyright © 2021 by the American Thoracic Society.
PY - 2021/1/15
Y1 - 2021/1/15
N2 - Rationale: Weight loss is recommended to treat obstructive sleep apnea (OSA). Objectives: To determine whether the initial benefit of intensive lifestyle intervention (ILI) for weight loss on OSA severity is maintained at 10 years. Methods: Ten-year follow-up polysomnograms of 134 of 264 adults in Sleep AHEAD (Action for Health in Diabetes) with overweight/obesity, type 2 diabetes mellitus, and OSA were randomized to ILI for weight loss or diabetes support and education (DSE). Measurements and Main Results: Change in apnea–hypopnea index (AHI) was measured. Mean 6 SE weight losses of ILI participants of 10.7 6 0.7, 7.4 6 0.7, 5.1 6 0.7, and 7.1 6 0.8 kg at 1, 2, 4, and 10 years, respectively, were significantly greater than the 1-kg weight loss at 1, 2, and 4 years and 3.5 6 0.8 kg weight loss at 10 years for the DSE group (P values < 0.0001). AHI was lower with ILI than DSE by 9.7, 8.0, and 7.9 events/h at 1, 2, and 4 years, respectively (P values < 0.0004), and 4.0 events/h at 10 years (P = 0.109). Change in AHI over time was related to amount of weight loss, baseline AHI, visit year (P values, 0.0001), and intervention independent of weight change (P = 0.01). OSA remission at 10 years was more common with ILI (34.4%) than DSE (22.2%). Conclusions: Participants with OSA and type 2 diabetes mellitus receiving ILI for weight loss had reduced OSA severity at 10 years. No difference in OSA severity was present between ILI and DSE groups at 10 years. Improvement in OSA severity over the 10-year period with ILI was related to change in body weight, baseline AHI, and intervention independent of weight change.
AB - Rationale: Weight loss is recommended to treat obstructive sleep apnea (OSA). Objectives: To determine whether the initial benefit of intensive lifestyle intervention (ILI) for weight loss on OSA severity is maintained at 10 years. Methods: Ten-year follow-up polysomnograms of 134 of 264 adults in Sleep AHEAD (Action for Health in Diabetes) with overweight/obesity, type 2 diabetes mellitus, and OSA were randomized to ILI for weight loss or diabetes support and education (DSE). Measurements and Main Results: Change in apnea–hypopnea index (AHI) was measured. Mean 6 SE weight losses of ILI participants of 10.7 6 0.7, 7.4 6 0.7, 5.1 6 0.7, and 7.1 6 0.8 kg at 1, 2, 4, and 10 years, respectively, were significantly greater than the 1-kg weight loss at 1, 2, and 4 years and 3.5 6 0.8 kg weight loss at 10 years for the DSE group (P values < 0.0001). AHI was lower with ILI than DSE by 9.7, 8.0, and 7.9 events/h at 1, 2, and 4 years, respectively (P values < 0.0004), and 4.0 events/h at 10 years (P = 0.109). Change in AHI over time was related to amount of weight loss, baseline AHI, visit year (P values, 0.0001), and intervention independent of weight change (P = 0.01). OSA remission at 10 years was more common with ILI (34.4%) than DSE (22.2%). Conclusions: Participants with OSA and type 2 diabetes mellitus receiving ILI for weight loss had reduced OSA severity at 10 years. No difference in OSA severity was present between ILI and DSE groups at 10 years. Improvement in OSA severity over the 10-year period with ILI was related to change in body weight, baseline AHI, and intervention independent of weight change.
KW - Apnea–hypopnea index
KW - Lifestyle modification
KW - Obstructive sleep apnea
KW - Polysomnogram
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U2 - 10.1164/rccm.201912-2511OC
DO - 10.1164/rccm.201912-2511OC
M3 - Article
C2 - 32721163
AN - SCOPUS:85100125844
SN - 1073-449X
VL - 203
SP - 221
EP - 229
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 2
ER -