May 13, 2022
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Interdisciplinary weight loss, lifestyle intervention improved sleep apnea severity in men

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Men with overweight or obesity and moderate to severe obstructive sleep apnea receiving CPAP assigned to undergo an interdisciplinary weight loss and lifestyle intervention had improved outcomes and health-related quality of life.

The Interdisciplinary Weight Loss and Lifestyle Intervention for OSA (INTERAPNEA) study, a parallel-group, open-label, randomized clinical trial, included 89 men (mean age, 54.1 years) in Spain with moderate to severe OSA and a BMI of 25 kg/m2 or higher who were receiving CPAP therapy. The trial was conducted from April 2019 to October 2020.

Change in apnea-hypopnea index after intervention vs. placebo
Data were derived from Carneiro-Barrera A, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.8212.

Participants were randomly assigned to usual care with CPAP therapy (n = 49) or an 8-week interdisciplinary weight loss and lifestyle intervention involving nutritional behavior change, aerobic exercise, sleep hygiene and alcohol and tobacco cessation along with CPAP therapy (n = 40).

The primary outcome was change in apnea-hypopnea index from baseline to 8 weeks and 6 months after the intervention. Secondary outcomes included changes in other OSA sleep-related outcomes, body weight and composition, cardiometabolic risk and health-related quality of life.

Participants in the intervention group had a 51% greater decrease in apnea-hypopnea index compared with participants in the control group (–21.2 vs. 2.5 events/hour) at 8 weeks. This reduction was 57% greater among participants in the intervention group at 6 months (–23.8 vs. –0.8 events/hour).

Forty-five percent of participants in the intervention group no longer required CPAP therapy and 15% achieved complete OSA remission by 8 weeks. At 6 months, 61.8% of participants in the intervention group no longer required CPAP therapy and 29.4% achieved complete OSA remission.

In addition, the intervention group had greater improvements compared with the usual care group in body weight (–7.1 kg vs. –0.3 kg), body composition (–2.9 kg vs. 1.4 kg), cardiometabolic risk (–6.5 mm Hg vs. 2.2 mm Hg) and health-related quality of life (0.8 points vs. 0.1 points) by 8 weeks.

“Given the high prevalence of OSA, its complex and reciprocal interaction with obesity and the fact that both conditions are readily treatable through an integrated behavioral intervention, health care professionals and policymakers might consider this approach as a central strategy to address the substantial impact of OSA on the health and welfare of populations,” Almudena Carneiro-Barrera, PhD, of the Sleep and Health Promotion Laboratory, Mind, Brain and Behavior Research Centre at the University of Granada in Spain, and colleagues wrote in JAMA Network Open.