Sustained improvement in mild obstructive sleep apnea after a diet- and physical activity-based lifestyle intervention: postinterventional follow-up.
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.
Tuomilehto
Henri
H
Institute of Clinical Medicine, Otorhinolaryngology, Kuopio University Hospital, and University of Eastern Finland, Kuopio, Finland. henri.tuomilehto@kuh.fi
Gylling
Helena
H
Peltonen
Markku
M
Martikainen
Tarja
T
Sahlman
Johanna
J
Kokkarinen
Jouko
J
Randell
Jukka
J
Tukiainen
Hannu
H
Vanninen
Esko
E
Partinen
Markku
M
Tuomilehto
Jaakko
J
Uusitupa
Matti
M
Seppä
Juha
J
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
D014280:Triglycerides