title: Tailored behavioral medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome and overweight.
abstract: OBJECTIVE
  This study aims to evaluate the effects on physical activity (PA) and eating behavior (EB) of a tailored behavioral medicine intervention and first-time continuous positive airway pressure (CPAP) treatment compared with first-time CPAP treatment and advice in patients with obstructive sleep apnea syndrome (OSAS) and overweight.
  
  
  METHODS
  Seventy-three patients (mean ± SD, 55 ± 12 years) with overweight (body mass index (BMI), 34.5 ± 4.8) and moderate or severe OSAS (Apnea-Hypopnea Index, 41.7 ± 20.9) scheduled for CPAP prescription were randomized to a control group (CPAP and advice on the association between weight and OSAS) or an experimental group (CPAP and a 6-month behavioral medicine intervention targeting PA and EB). At baseline and after 6 months, eating behavior (food frequency screening and Dutch Eating Behavior Questionnaire), weight, BMI, and waist circumference were assessed at one point, while PA and sedentary time were measured with accelerometry during 4 days.
  
  
  RESULTS
  The experimental group reduced 2.1 kg (±4.6) in weight and 3 cm (±4.9) in waist circumference, significantly more than the control group. At 6 months, the experimental group ate more fruit and fish/shellfish than the control group. Low and moderate to vigorous PA did not change over time either within or between groups. Regarding BMI, steps, and sedentary time, there were within-group differences but no differences between groups.
  
  
  CONCLUSIONS
  The behavioral medicine intervention did not change physical activity but facilitated changes in EB in patients with OSAS and overweight. The amount of weight loss and reduction in waist circumference favored the participants receiving this treatment. Since the strategies for achieving behavioral changes were tailored according to the individual's goals and personal functional behavioral analyses and progressed slowly in a graded manner, it might require higher PA quotas or a period longer than 6 months to reveal a behavioral change of larger proportions.
authors.affiliation: Department of Neuroscience, Physiotherapy, Uppsala University, Box 593, BMC, Uppsala, SE-751 24, Sweden, helena.igelstrom@neuro.uu.se.
authors.forename: Helena
authors.initials: H
authors.lastname: Igelström
authors.affiliation: Department of Neuroscience, Physiotherapy, Uppsala University, Box 593, BMC, Uppsala, SE-751 24, Sweden, helena.igelstrom@neuro.uu.se.
authors.forename: Igelström
authors.initials: I
authors.lastname: Helena
authors.forename: Margareta
authors.initials: M
authors.lastname: Emtner
authors.forename: Emtner
authors.initials: E
authors.lastname: Margareta
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.forename: Lindberg
authors.initials: L
authors.lastname: Eva
authors.forename: Pernilla
authors.initials: P
authors.lastname: Åsenlöf
authors.forename: Åsenlöf
authors.initials: Å
authors.lastname: Pernilla
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D050177:Overweight / Q000523:psychology* / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D013548:Sweden; D055105:Waist Circumference