Sleep Apnea Limits Response to Obesity Interventions

In follow up to yesterday’s post on the positive impact of CPAP treatment for obstructive sleep apnea (OSA) on weight and cardiometabolic risk factors, here is another study highlighting the importance of diagnosing and managing OSA in obesity patients.

This study by Anne-Laure Borel and colleagues from the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada, published in THORAX, the researchers show that OSA attenuates the effects of a lifestyle intervention programme in men with visceral obesity.

The authors compare the response of 77 men, selected on the basis of increased waist circumference (≥90 cm) and dyslipidaemia (triglycerides ≥1.69 and/or high-density lipoprotein (HDL) cholesterol <1.03 mmol/litre) to a 1-year healthy eating, physical activity/exercise intervention programme.

After the 1-year lifestyle intervention, despite similar compliance to the programme, the 28 men with sleep apnoea syndrome at baseline (ODI ≥10 events/h) showed smaller reductions in body mass index, waist circumference, triglycerides and smaller increases in HDL cholesterol and adiponectin than the 49 men without sleep apnoea.

In addition, the higher the baseline ODI and the time spent under 90% oxygen saturation, the lower the reductions in fat mass and visceral adiposity, and the smaller the improvement in glucose/insulin homeostasis indices after 1 year.

This finding certainly supports the notion that diagnosis and management of OSA has to be seen as an essential part of obesity management.

Here again (according to Helpguide) are the most common symptoms associated with sleep apnea:

Major signs and symptoms of sleep apnea

  • Loud and chronic snoring
  • Choking, snorting, or gasping during sleep
  • Long pauses in breathing
  • Daytime sleepiness, no matter how much time you spend in bed

Other common signs and symptoms of sleep apnea include:

  • Waking up with a dry mouth or sore throat
  • Morning headaches
  • Restless or fitful sleep
  • Insomnia or nighttime awakenings
  • Going to the bathroom frequently during the night
  • Waking up feeling out of breath
  • Forgetfulness and difficulty concentrating
  • Moodiness, irritability, or depression

Signs and symptoms of sleep apnea in children

While obstructive sleep apnea can be common in children, it’s not always easy to recognize. In addition to continuous loud snoring, children with sleep apnea may adopt strange sleeping positions and suffer from bedwetting, excessive perspiration at night, or night terrors. Children with sleep apnea may also exhibit changes in their daytime behavior, such as:

  • Hyperactivity or inattention
  • Developmental and growth problems
  • Decrease in school performance
  • Irritable, angry, or hostile behavior
  • Breathing through mouth instead of nose
Edmonton, Alberta

ResearchBlogging.orgBorel AL, Leblanc X, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP, & Series F (2012). Sleep apnoea attenuates the effects of a lifestyle intervention programme in men with visceral obesity. Thorax PMID: 22396182