The impact of diet and lifestyle management strategies for obstructive sleep apnoea in adults: a systematic review and meta-analysis of randomised controlled trials.
OBJECTIVE
To systematically evaluate the impact of diet, exercise and lifestyle modification programmes on indices of obesity, Obstructive Sleep Apnoea (OSA) parameters and quality of life (QoL) in adults with OSA.


METHODS
Electronic databases were searched to identify randomised controlled trials published in English with an intervention based on dietary weight loss, exercise and/or lifestyle programme in adults with OSA. Meta-analyses were conducted using random-effects models.


RESULTS
Twelve studies met the inclusion criteria with nine comparing similar interventions. Diet and diet plus continuous positive airway pressure (CPAP) therapy were compared in three studies (n = 261), and intensive lifestyle programmes and routine care were compared in six studies (n = 483). Diet with CPAP therapy reduced weight by -2.64 kg (95 % Confidence Interval (CI) -3.98, -1.30, I (2) = 0 %) compared with diet alone. No differences were observed for QoL or Epworth Sleepiness Scale. A significant reduction in weight was seen in participants receiving an intensive lifestyle intervention of -5.65 kg (95 % CI -10.91, -0.40, I(2) = 95.7 %) compared with controls. Reductions were also observed for waist circumference (-5.80 cm, 95 % CI -8.64, -2.96, I(2) = 77.7 %), body mass index (BMI) (-2.33 kg/m(2), 95 % CI -3.41, -1.24, I(2) = 78.8 %) and the Apnoea Hypopnoea Index (AHI) (-4.55 events/h, 95 % CI -7.12, -1.98, I(2) = 54.4 %) but with high levels of heterogeneity.


CONCLUSIONS
Intensive lifestyle management can significantly reduce obesity indices and improve AHI. Future research is required to investigate this effect due to a limited number of studies identified.
Department of Health Sciences, University of Leicester, Leicester, UK. mt221@le.ac.uk
Maria-Anna
MA
Thomasouli
Emer M
EM
Brady
Melanie J
MJ
Davies
Andrew P
AP
Hall
Kamlesh
K
Khunti
Danielle H
DH
Morris
Laura J
LJ
Gray
D015992:Body Mass Index; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure; D005247:Feeding Behavior; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000150:complications / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D055105:Waist Circumference; D015431:Weight Loss