Can Weight Loss Cure Sleep Apnea?

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Sleep apnea poses a serious health risk to millions of people in the United States—estimates range from 12 million to 20 million—many of whom don’t even know they have it.

The disruptive snoring which often first alerts sufferers (or their partners) may be the most obvious and irritating symptom, but the potential consequences of this severe sleep disturbance are far more dangerous and debilitating. People with sleep apnea are at increased risk for high blood pressure and stroke, have a 30% higher risk of heart attack or premature death, and can suffer significant memory loss, high blood pressure, and seizures. Their daily quality of life is also degraded by several sleep deprivation.

Because patients who report sleep apnea are often overweight, doctors have generally assumed that the conditions are linked and that these patients should concentrate above all on losing weight. But actual research to support and quantify that treatment recommendation has been scarce. According to Gary Foster of the Temple University Center for Obesity Research and Education, “There are very few studies that show whether the recommended amount of weight loss—about 10 percent—is enough to sufficiently improve sleep apnea.”

Recently, however, researchers at seven prominent universities and clinics lead by Temple’s Foster joined in a major study to determine whether losing weight decreases the incidence of sleep apnea among type 2 diabetics. Their findings, published in the Archives of Internal Medicine (September 28, 2009) are extremely encouraging.

The Sleep AHEAD Study

The seven participating research centers—Temple University, the University of Pittsburgh, Brown University, the University of Pennsylvania, Columbia University, Wake Forest University, and Clinilabs contract research organization—were already conducting a trial program called Look AHEAD, which was studying the health benefits of lifestyle changes among 5,145 adults age 45 to 75 suffering from both obesity and type 2 diabetes.

The sleep apnea research group identified a subset of these Look AHEAD patients for another trial called Sleep AHEAD. 264 subjects were chosen and divided into two groups given radically different weight-loss programs—one a highly structured and detailed regimen, the other more loosely informational and advisory.

These two groups showed widely differing outcomes for both weight loss and sleep apnea. Participants in the structured weight loss program lost 24 pounds on average, and showed a significant reduction in their sleep apnea. More than 13 percent achieved completed elimination of their apnea. Patients in the second group lost a single pound and their sleep apnea actually worsened.

The upshot of this study strongly supports the received wisdom about treating sleep apnea. As Foster notes, “patients can expect a significant improvement in their sleep apnea with weight loss. And a reduction in sleep apnea has a number of benefits for overall health and well-being.”

To read an abstract of this report, “A Randomized Study on the Effect of Weight Loss on Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes: The Sleep AHEAD Study,” by Gary D. Foster; Kelley E. Borradaile; Mark H. Sanders; Richard Millman; Gary Zammit; Anne B. Newman; Thomas A. Wadden; David Kelley; Rena R. Wing; F. Xavier Pi-Sunyer; David Reboussin; Samuel T. Kuna; for the Sleep AHEAD Research Group of the Look AHEAD Research Group, click here.

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