title: Weight reduction improves sleep, sleepiness and metabolic status in obese sleep apnoea patients.
abstract: CONCLUSIONS
  
  
  
  METHODS
  In this prospective intervention study, 33 obese patients with obstructive sleep apnoea syndrome (OSAS) (24 men, 9 women) were consecutively enrolled for a weight reduction program at the Obesity Unit, Karolinska University Hospital. 23 of 33 patients used OSAS-device, 19 with Continuous Positive Airway Pressure and 4 with Mandibular Retaining Device. The patients were investigated with questionnaires, blood tests and ambulant nocturnal polysomnography before and after a 6-month program. Patients with OSAS-device slept without it during the sleep studies. The intervention consisted of 8 weeks low calorie diet and group meetings, followed by a day-care program of behaviour change support.
  
  
  RESULTS
  27 of 33 patients (82%, 21 men and 6 women) completed the study. After the intervention there were highly significant decreases (p < 0.001) in Body Mass Index from mean(S.D.) 40(5) to 34(3), apnoea-hypopnoea index from 43(24) to 26(20) and Epworth Sleepiness Scale (ESS)-score from 9(4) to 6(4). Sleep quality (arousal index, sleep efficiency, percentage deep sleep) and metabolic status (blood pressure, blood glucose levels, lipidemia) were also significantly improved. There was a significant correlation between increased percentage deep sleep and reduced ESS-score. There were no differences due to gender or use/no use of OSAS-device.
  
  
  CONCLUSIONS
  The results suggest that weight loss, induced by low calorie diet and behaviour change support, significantly improves nocturnal respiratory parameters, sleep quality, daytime sleepiness and metabolic status in obese OSAS patients after 6 months.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden. Electronic address:pia.nerfeldt@karolinska.se.
authors.forename: Pia
authors.initials: P
authors.lastname: Nerfeldt
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden.
authors.forename: Bengt Y
authors.initials: BY
authors.lastname: Nilsson
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden.
authors.forename: Liliana
authors.initials: L
authors.lastname: Mayor
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden.
authors.forename: Joanna
authors.initials: J
authors.lastname: Uddén
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden.
authors.forename: Stephan
authors.initials: S
authors.lastname: Rössner
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital-Huddinge, SE-141 86, Stockholm, Sweden.
authors.forename: Danielle
authors.initials: D
authors.lastname: Friberg