Qiong Ou1, Baixin Chen1, Kelly A Loffler2, Yuanming Luo3, Xilong Zhang4, Rui Chen5, Qian Wang1, Luciano F Drager6, Geraldo Lorenzi-Filho6, Michael Hlavac7, Nigel McArdle8, Sutapa Mukherjee8, Olga Mediano9, Ferran Barbe10, Craig S Anderson11, R Doug McEvoy12, Richard J Woodman13. 1. Sleep Center, Respiratory and Critical Medical Department, Guangdong Geriatric Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. 2. Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia. 3. Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou, Guangdong, China. 4. Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. 5. Hospital of Soochow University, Suzhou, Jiangsu, China. 6. Instituto do Coracao and Hospital Universitario, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. 7. Christchurch Hospital, Christchurch, New Zealand. 8. West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. 9. University Hospital of Guadalajara, Guadalajara, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. 10. Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Institut de Recerca Biomedica de Lleida, Lleida, Spain. 11. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, NSW, Australia. 12. Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia; Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, SA, Australia. Electronic address: doug.mcevoy@flinders.edu.au. 13. Flinders Centre for Epidemiology and Biostatistics (Dr Woodman), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Abstract
BACKGROUND: Although recent evidence suggests that OSA treatment may cause weight gain, the long-term effects of CPAP on weight are not well established. METHODS: This study was a post hoc analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) study, a multicenter, randomized trial of CPAP plus standard care vs standard care alone in adults with a history of cardiac or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants. RESULTS: A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [-0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, -0.14 kg [-0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control subjects without CPAP (mean difference, 0.38 kg [95% CI, 0.04 to 0.73]; P = .031), there were no between-group differences in other anthropometric variables, nor were there any differences between female high CPAP adherers and matched control subjects. CONCLUSIONS:Long-term CPAP use in patients with comorbid OSA and cardiovascular disease does not result in clinically significant weight change. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00738179; URL: www.clinicaltrials.gov.
RCT Entities:
BACKGROUND: Although recent evidence suggests that OSA treatment may cause weight gain, the long-term effects of CPAP on weight are not well established. METHODS: This study was a post hoc analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) study, a multicenter, randomized trial of CPAP plus standard care vs standard care alone in adults with a history of cardiac or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants. RESULTS: A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [-0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, -0.14 kg [-0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control subjects without CPAP (mean difference, 0.38 kg [95% CI, 0.04 to 0.73]; P = .031), there were no between-group differences in other anthropometric variables, nor were there any differences between female high CPAP adherers and matched control subjects. CONCLUSIONS: Long-term CPAP use in patients with comorbid OSA and cardiovascular disease does not result in clinically significant weight change. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00738179; URL: www.clinicaltrials.gov.
Authors: Sina A Gharib; Amanda L Hurley; Michael J Rosen; James C Spilsbury; Amy E Schell; Reena Mehra; Sanjay R Patel Journal: Sleep Date: 2020-06-15 Impact factor: 5.849
Authors: Louisa Schaller; Michael Arzt; Bettina Jung; Carsten A Böger; Iris M Heid; Stefan Stadler Journal: Front Neurol Date: 2021-12-02 Impact factor: 4.003