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The SLEEP AHEAD Study: Weight Loss Improves Obstructive Sleep Apnea

>> Saturday, October 3, 2009



Obstructive sleep apnea (OSA) is a huge problem. Did you know that 25% of adults are at risk of having OSA? Amongst obese type 2 diabetics, a whopping 86% suffer this disorder. Even worse - many don't know that they have it.




In obstructive sleep apnea, breathing is abnormal during sleep because of narrowing or closure of the throat; this results in air movement being periodically diminished or stopped. It is a serious condition that can affect a person's ability to safely perform normal daily activities and can affect long term health.

It is a well known fact that obesity increases the risk of developing obstructive sleep apnea, and as such, it would make sense that weight loss would improve OSA; however, this had not been definitively proven - until this week.

In the Archives of Internal Medicine, Gary Foster and colleagues published results from their SLEEP AHEAD study. They enrolled 264 overweight or obese patients with type 2 diabetes, and randomized them to receive either a portion controlled diet plus a moderate exercise program, versus three group diabetes education sessions without a specific weight loss plan, for a 1-year period. People in the diet group lost 24 lbs, compared with just over 1 lb in controls. Overall, there was a marked improvement in OSA in the diet group, while OSA worsened in the control group, despite not gaining weight. In addition, more than three times as many participants in the diet group had total remission of their OSA compared to the control group.

Take home messages here are:

1. If you have a risk factor for OSA, or symptoms of OSA, speak with your family doctor about it, as OSA is often underdiagnosed. Risk factors include overweight, male gender, increasing age, and use of sedative medications. Symptoms can include restless sleep, morning headaches, awakening with a choking sensation, awakening feeling unrested, and having difficulty concentrating.

2. We now have clear evidence that in overweight individuals, weight loss improves OSA. Though this study was conducted in diabetics, it is likely that this weight loss benefit would extend to non diabetics as well.

3. A big weight loss and significant improvement in OSA was seen using simple measures: portion control and moderate exercise! Portion control in this study was in the form of liquid meal replacements, snack bars, and portion controlled meals (such as Healthy Choice and Lean Cuisine), which are great options; a portion control plate is a good choice as well!

Dr. Sue © 2009 http://www.drsue.ca/ drsuetalks@gmail.com



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