title: Sustained improvement in mild obstructive sleep apnea after a diet- and physical activity-based lifestyle intervention: postinterventional follow-up.
abstract: BACKGROUND
  Obesity is the most important risk factor for obstructive sleep apnea (OSA). Weight-reduction programs have been observed to represent effective treatment of overweight patients with OSA. However, it is not known whether beneficial changes remain after the end of the intervention.
  
  
  OBJECTIVE
  The aim of the study was to assess the long-term efficacy of a lifestyle intervention based on a healthy diet and physical activity in a randomized, controlled, 2-y postintervention follow-up in OSA patients.
  
  
  METHODS
  Eighty-one consecutive overweight [body mass index (in kg/m(2)): 28-40] adult patients with mild OSA were recruited. The intervention group completed a 1-y lifestyle modification regimen that included an early 12-wk weight-reduction program with a very-low-calorie diet. The control group received routine lifestyle counseling. During the second year, no dietary counseling was offered. Change in the apnea-hypopnea index (AHI) was the main objective outcome variable, and changes in symptoms were used as a subjective measurement.
  
  
  RESULTS
  A total of 71 patients completed the 2-y follow-up. The mean (± SD) changes in diet and lifestyle with simultaneous weight reduction (-7.3 ± 6.5 kg) in the intervention group reflected sustained improvements in findings and symptoms of OSA. After 2 y, the reduction in the AHI was significantly greater in the intervention group (P = 0.049). The intervention lowered the risk of OSA at follow-up; the adjusted odds ratio for OSA was 0.35 (95% CI: 0.12-0.97; P = 0.045).
  
  
  CONCLUSIONS
  Favorable changes achieved by a 1-y lifestyle intervention aimed at weight reduction with a healthy diet and physical activity were sustained in overweight patients with mild OSA after the termination of supervised lifestyle counseling. This trial was registered at clinicaltrials.gov as NCT00486746.
authors: Institute of Clinical Medicine, Otorhinolaryngology, Kuopio University Hospital, and University of Eastern Finland, Kuopio, Finland. henri.tuomilehto@kuh.fi
authors: Henri
authors: H
authors: Tuomilehto
authors: Helena
authors: H
authors: Gylling
authors: Markku
authors: M
authors: Peltonen
authors: Tarja
authors: T
authors: Martikainen
authors: Johanna
authors: J
authors: Sahlman
authors: Jouko
authors: J
authors: Kokkarinen
authors: Jukka
authors: J
authors: Randell
authors: Hannu
authors: H
authors: Tukiainen
authors: Esko
authors: E
authors: Vanninen
authors: Markku
authors: M
authors: Partinen
authors: Jaakko
authors: J
authors: Tuomilehto
authors: Matti
authors: M
authors: Uusitupa
authors: Juha
authors: J
authors: Seppä
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D049628:Body Size; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000150:complications; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides