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Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: longitudinal data from the ESADA cohort
Author(s) -
Basoglu Ozen K.,
Zou Ding,
Tasbakan Mehmet S.,
Hedner Jan,
Ryan Silke,
Verbraecken Johan,
Escourrou Pierre,
Antalainen Ulla,
Kvamme John A.,
Bonsignore Maria R.,
Schiza Sofia,
Grote Ludger
Publication year - 2018
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12705
Subject(s) - medicine , body mass index , obstructive sleep apnea , continuous positive airway pressure , positive airway pressure , epworth sleepiness scale , sleep apnea , confidence interval , obesity , anesthesia , waist , apnea , polysomnography , cardiology
Summary The effect of positive airway pressure treatment on weight and markers of central obesity in patients with obstructive sleep apnea remains unclear. We studied the change in body weight and anthropometric measures following positive airway pressure treatment in a large clinical cohort. Patients with obstructive sleep apnea with positive airway pressure treatment from the European Sleep Apnea Database registry ( n = 1,415, 77% male, age 54 ± 11 [mean ± SD ] years, body mass index 31.7 ± 6.4 kg/m 2 , apnea–hypopnea index 37 ± 24 n per hr, Epworth Sleepiness Scale 10.2 ± 5.0) were selected. Changes in body mass index and neck/waist/hip circumferences at baseline and at follow‐up visit were analysed. Overall, body mass index (0.0 [95% confidence interval, −0.1 to 0.2] kg/m 2 ) and neck circumference (0.0 (95% confidence interval, −0.1 to 0.1] cm) were unchanged after positive airway pressure treatment compared with baseline (follow‐up duration 1.1 ± 1.0 years and compliance 5.2 ± 2.1 hr per day). However, in non‐obese (body mass index <30 kg/m 2 ) patients, positive airway pressure treatment was associated with an increased body mass index and waist circumference (0.4 [0.3–0.5] kg/m 2 and 0.8 [0.4–1.2] cm, respectively, all p < 0.05), and weight gain was significantly associated with higher positive airway pressure compliance and longer positive airway pressure treatment duration. In the obese subgroup, body mass index was reduced after positive airway pressure treatment (−0.3 [−0.5 to −0.1] kg/m 2 , p < 0.05) mainly in patients with a strong reduction in Epworth Sleepiness Scale. In conclusion, positive airway pressure therapy was not found to systematically change body mass index in the European Sleep Apnea Database cohort, but the response was heterogeneous. Our findings suggest that weight gain may be restricted to an obstructive sleep apnea phenotype without established obesity. Lifestyle intervention needs to be considered in both lean and obese patients with obstructive sleep apnea receiving positive airway pressure treatment.