title: Weight loss from lifestyle interventions and severity of sleep apnoea: a systematic review and meta-analysis.
abstract: BACKGROUND
  Excess body weight is a risk factor for obstructive sleep apnoea (OSA). The aim of the systematic review was to establish whether weight loss via lifestyle interventions such as diet and exercise are useful in the treatment of OSA.
  
  
  METHODS
  A literature search was conducted between 1980 and February 2012. Systematic reviews and randomised controlled trials (RCTs) with participants who had OSA, were overweight or obese, and who had undergone lifestyle interventions with the aim of improving sleep apnoea were included. Meta analyses were conducted for a subset of RCTs with appropriate data.
  
  
  RESULTS
  Two systematic reviews and eight RCTs were included. Meta-analyses were conducted for four RCTs comparing intensive lifestyle interventions to a control. The overall weighted mean differences for weight change, change in apnoea -hypopnoea index (AHI) and change in oxygen desaturation index of ≥4% were as follows: -13.76 kg (95% confidence interval (CI) -19.21, --8.32), -16.09 (95% CI -25.64, -6.54) and -14.18 (95% CI -24.23, -4.13), respectively. Although high heterogeneity within the meta analyses, all studies favoured the interventions. Long-term follow-up data from three RCTs suggest that improvements in weight and AHI are maintained for up to 60 months.
  
  
  CONCLUSIONS
  Intensive lifestyle interventions are effective in the treatment of OSA, resulting in significant weight loss and a reduction in sleep apnoea severity. Weight loss via intensive lifestyle interventions could be encouraged as a treatment for mild to moderate OSA.
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, Vic, Australia.
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Mitchell
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, Vic, Australia. Electronic address: zoe.davidson@monash.edu.
authors.forename: Zoe E
authors.initials: ZE
authors.lastname: Davidson
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, Vic, Australia.
authors.forename: Maxine
authors.initials: M
authors.lastname: Bonham
authors.affiliation: Department of Respiratory and Sleep Medicine, Eastern Health, Melbourne, Vic, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Vic, Australia.
authors.forename: Denise M
authors.initials: DM
authors.lastname: O'Driscoll
authors.affiliation: Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Vic, Australia; Monash Lung and Sleep, Monash Health, Melbourne, Vic, Australia.
authors.forename: Garun S
authors.initials: GS
authors.lastname: Hamilton
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, Vic, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
mesh_terms: D006801:Humans; D008019:Life Style; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Lifestyle intervention; Obstructive sleep apnoea; Systematic review; Treatment; Weight loss