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Obesity has been linked to exacerbating Obstructive Sleep Apnea in patients. Paradoxically however, effective CPAP therapy has been noted to lead to weight increases even while improving hypersomnia and daytime neurocognitive functioning. Prior studies have demonstrated inconsistent results regarding weight changes while on CPAP therapy. Our study aims to clarify these inconsistencies and provide specific recommendations for CPAP compliant patients to prevent weight gain. Methods 393 OSA patients were seen for multiple follow ups since initiation of CPAP therapy at a single center sleep clinic. Every visit their weight would be updated along with CPAP compliance. Data was assessed on 1 month, 6 month, and 12 month intervals. Exclusion criteria include diuretic use, diet/exercise additions, and discontinuation of CPAP therapy before the full observation window. Results Patients with long term use of their CPAP devices had an average increase of 2.68±11.29 lbs after a year. 233 participants gained weight (an average of 9.8±7.3 lbs) while 141 participants lost weight (an average of -8.5±7.2 lbs) with 19 participants showing no weight change. This weight change could be observed starting as early as one month after CPAP initiation. Conclusion CPAP therapy is most likely linked to a lasting increase in weight. Recommendations and patient education for OSA patients should be modified to include an exercise component (10,000 steps/day) and/or caloric restriction (2200 low carb diet) to offset this weight increase. Further study is needed to assess the impact such recommendations could have in long term OSA care beyond the southeast USA. Support (if any) Pulmonary Allergy &amp; Sleep Center of Augusta

464 Long term effects of Continuous Positive Airway Pressure on the weight of Obstructive Sleep Apnea patients in the southeast USA