Helen Truby1, Bradley A Edwards2,3, Kaitlin Day4, Denise M O'Driscoll5,6, Alan Young5,6, Ladan Ghazi4, Claire Bristow7, Kerryn Roem4, Maxine P Bonham4, Chiara Murgia8, Terry P Haines9, Garun S Hamilton10,11. 1. School of Human Movement and Nutrition Sciences, University of Queensland, Melbourne, VIC, Australia. 2. Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia. 3. School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia. 4. School of Clinical Sciences, Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia. 5. Eastern Health, Department of Respiratory and Sleep Medicine, Melbourne, VIC, Australia. 6. Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia. 7. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 8. School of Agriculture and Food, Melbourne University, Melbourne, VIC, Australia. 9. School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia. 10. School of Clinical Sciences, Monash University, Melbourne, VIC, Australia. garun.hamilton@monashhealth.org. 11. Monash Health, Department of Lung, Sleep, Allergy and Immunology, Melbourne, VIC, Australia. garun.hamilton@monashhealth.org.
Abstract
BACKGROUND/ OBJECTIVES: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. METHODS: Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. RESULTS: After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [-0.3 to 0.36], p = 0.86). CONCLUSIONS: The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.
BACKGROUND/ OBJECTIVES: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. METHODS: Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. RESULTS: After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [-0.3 to 0.36], p = 0.86). CONCLUSIONS: The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.