Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

Table 1

A summary of studies of behaviourally and pharmacologically induced weight loss in obstructive sleep apnoea.

Paper	Design	n	% Male	Group	Intervention	Followup months	ΔBMI	ΔAHI	% With OSA cure
Johansson et al., 2011 [42]	Prospective cohort	63	100	BMI 30–40, AHI ≥ 15	VLCD and weight maintenance programme	12	35→31	36→19	10
Nerfeldt et al., 2010 [47]	Prospective cohort	33	73%	BMI ≥ 30, AHI ≥ 10 and/or ODI ≥ 6, OSAS symptoms	LCD and behavioural change support	24	40→35	43→28	?
Johansson et al., 2009 [41]	Randomised, controlled, and parallel group	63	100	BMI 30–40, AHI ≥ 15	VLCD	2	34→29; v; 35→35	37→12; v; 37→35	17 v 0
Tuomilehto et al., 2009 [46]	Randomised, controlled, and parallel group	72	74	BMI 28–40 kg/m^2, AHI 5–15 events/hr	VLCD, supervised lifestyle counselling	12	33→?; v; 31→?	10→6; v; 9→10	63%; v; 35%
Barnes et al., 2009 [45]	Cohort	12	25	BMI > 30 kg/m^2, AHI 10–50 events/hr	VLCD and exercise programme	12	36→30	25→18	0
Foster et al., 2009 [94]	Randomised, controlled, and parallel group	264	41	BMI ≥ 25 kg/m^2, AHI ≥ 5 events/hr, type 2 diabetes	Intensive lifestyle intervention (diet/exercise)	12	37→?; v; 37→?	23→18; v; 24→28	14 v 4
Kemppainen et al., 2008 [44]	Randomised, controlled, and parallel group	52	79	BMI 28–40 kg/m^2, AHI 5–15 events/hr	VLCD, supervised lifestyle counselling	3	33→?; v; 32→?	11→8; v; 9→8	?
Kajaste et al., 2004 [48]	Cohort	31	100	BMI > 35 kg/m^2, ODI > 10 events/hr	VLCD, CBT weight reduction program	24	44→40	51→32 (ODI)	?
Kansanen et al., 1998 [40]	Prospective, cohort	15	93	Overweight with OSA	VLCD	3	38→35	31→19 (ODI)	20
Suratt et al., 1992 [39]	Cohort	8	62	Obese with OSA	VLCD	?	54→46	90→62	?
Ferland et al., 2009 [56]	Nonrandomised, parallel group	40	88	BMI ≥ 30 kg/m^2, OSAS	Sibutramine, diet and exercise v CPAP	12	37→35; v; 36→36	40→37; v; 44→4	?
Phillips et al., 2009 [55]	Cohort	93	100	BMI 30–38 kg/m^2, RDI ≥ 15 events/hr	Sibutramine, diet and exercise	6	34→32	46→30 (RDI)	?
Yee et al., 2007 [54]	Cohort	87	100	BMI 30–38 kg/m^2, RDI ≥ 15 events/hr	Sibutramine, diet and exercise	6	34→32	46→30 (RDI)	5
Martinez and Basile, 2005 [53]	Randomised, double-blind, and controlled group	19	100	BMI 25–35 kg/m^2, AHI ≥ 10 events/hr	Sibutramine v placebo	1	?	28→27; v; 28→28	?

Abbreviations: ΔAHI: apnoea hypopnoea index before and after intervention, ΔBMI: body mass index before and after intervention, CBT: cognitive behavioural therapy, CPAP: continuous positive airway pressure, 𝑛 number, ODI: oxygen desaturation index, OSA: obstructive sleep apnoea, OSAS: obstructive sleep apnoea syndrome, RDI: respiratory disturbance index, (V)LCD: (very) low calorie diet.