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Obstructive sleep apnoea

Moderate weight loss can reduce OSA impact

Weight loss of just 5% was enough to prevent the disease from worsening and even cure it in a long-term follow-up

Even a moderate weight reduction can prevent the progression of obstructive sleep apnoea (OSA), and even cure it, according to a four-year Finish follow-up study 'The impact of weight reduction in the prevention of the progression of obstructive sleep apnea: an explanatory analysis of a 5-year observational follow-up trial',published in Sleep Medicine. The study focused on the effects of weight loss on OSA, and according to the researchers, demonstrated for the first time that a sustained weight loss of just 5% was enough to prevent the disease from worsening and even cure it in a long-term follow-up.

Although obesity is the most important risk factor for OSA and weight gain represents a high risk for the further progression of the disease towards the more severe forms, particularly in patients who already have a partial obstruction of their upper airways associated with mild OSA. However, no studies have focused on the prevention of the progression of OSA, no national programmes for screening OSA or preventing the progression of the disease, nor are such programmes even planned at the moment around the world.

This study, conducted in Kuopio University Hospital, Finland, in collaboration with the University of Eastern Finland between 2004 and 2013, included participants who were moderately obese adult patients with mild OSA. The participants underwent either a 12-month supervised lifestyle intervention programme or were given standard care consisting of general verbal and written information about diet and physical activity.

The main hypothesis was that even a moderate (5%, -5kg) but sustained weight reduction can achieve an improvement in OSA, thus preventing the progression of the disease when the treatment is started in the early stages of OSA.

The participants were divided into the two groups according to the weight change at five years, using the 5% weight loss as a cutoff point, which was later referred to as the successful (n=20) or unsuccessful groups (n=27). The change in apnoea-hypopnea index (AHI) was the main objective outcome variable.


A total of 57 patients participated in the five-year follow-up. At five years, the change in AHI between the groups was significant in the successful group (−3.5 [95% confidence interval, −6.1 to −0.9) compared with the unsuccessful group (p=0.002). Successful weight reduction achieved an 80% reduction in the incidence of progression of OSA compared to the unsuccessful group (p=0.016).

“This study provides first time long-term evidence that even a modest weight reduction can result in marked improvements of OSA and metabolism in overweight patients,” said the study authors. “These positive changes are sustained even four years after the cessation of the active intervention, and the progression of the disease is thus prevented.”

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