TY - JOUR
T1 - Bidirectional Relationships Between Weight Change and Sleep Apnea in a Behavioral Weight Loss Intervention
AU - Kline, Christopher E.
AU - Burke, Lora E.
AU - Sereika, Susan M.
AU - Imes, Christopher C.
AU - Rockette-Wagner, Bonny
AU - Mendez, Dara D.
AU - Strollo, Patrick J.
AU - Zheng, Yaguang
AU - Rathbun, Stephen L.
AU - Chasens, Eileen R.
N1 - Publisher Copyright:
© 2018 Mayo Foundation for Medical Education and Research
PY - 2018/9
Y1 - 2018/9
N2 - Objective: To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention. Patients and Methods: Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity. Results: At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA. Conclusion: Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling.
AB - Objective: To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention. Patients and Methods: Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity. Results: At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA. Conclusion: Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling.
KW - Adult
KW - Aged
KW - Female
KW - Humans
KW - Linear Models
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Obesity/complications
KW - Overweight/complications
KW - Sleep Apnea, Obstructive/diagnosis
KW - Treatment Outcome
KW - Weight Loss
KW - Weight Reduction Programs
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UR - http://www.scopus.com/inward/citedby.url?scp=85050891364&partnerID=8YFLogxK
U2 - 10.1016/j.mayocp.2018.04.026
DO - 10.1016/j.mayocp.2018.04.026
M3 - Article
C2 - 30082081
AN - SCOPUS:85050891364
SN - 0025-6196
VL - 93
SP - 1290
EP - 1298
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 9
ER -