title: Effects of exercise and weight loss in older adults with obstructive sleep apnea.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is prevalent among older individuals and is linked to increased cardiovascular disease morbidity. This study examined the change in OSA severity after exercise training and dietary-induced weight loss in older adults and the association of the changes in OSA severity, body composition, and aerobic capacity with arterial distensibility.
  
  
  METHODS
  Obese adults (n = 25) with OSA, age 60 yr or older, were instructed to participate in supervised exercise (3 d·wk) and follow a calorie-restricted diet. Baseline assessments of OSA parameters, body weight and composition, aerobic capacity, and arterial distensibility were repeated at 12 wk.
  
  
  RESULTS
  Nineteen participants completed the intervention. At 12 wk, there were reductions in body weight (-9%) and percentage of total body fat (-5%) and trunk fat (-8%) whereas aerobic capacity improved by 20% (all P < 0.01). The apnea-hypopnea index decreased by 10 events per hour (P < 0.01) and nocturnal SaO2 (mean SaO2) improved from 94.9% at baseline to 95.2% after intervention (P = 0.01). Arterial distensibility for the group was not different from that at baseline (P = 0.99), yet individual changes in distensibility were associated with the change in nocturnal desaturations (r = -0.49, P = 0.03) but not with the change in body weight, apnea-hypopnea index, or aerobic capacity.
  
  
  CONCLUSIONS
  The severity of OSA was reduced after an exercise and weight loss program among older adults, suggesting that this lifestyle approach may be an effective first-line nonsurgical and nonpharmacological treatment for older patients with OSA.
authors.affiliation: 1Department of Kinesiology, Towson University, Towson, MD; 2Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD; 3Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore MD; and 4Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Devon A
authors.initials: DA
authors.lastname: Dobrosielski
authors.forename: Susheel
authors.initials: S
authors.lastname: Patil
authors.forename: Alan R
authors.initials: AR
authors.lastname: Schwartz
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Stewart
mesh_terms: D050154:Adiposity; D000368:Aged; D015308:Anaerobic Threshold; D031204:Caloric Restriction; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy; D010100:Oxygen / Q000097:blood; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D059289:Vascular Stiffness; D015431:Weight Loss
chemical_list: D010100:Oxygen