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Randomized Controlled Trial
. 2018 Sep;22(3):653-661.
doi: 10.1007/s11325-017-1597-z. Epub 2017 Dec 8.

Improvement in obstructive sleep apnea after a tailored behavioural sleep medicine intervention targeting healthy eating and physical activity: a randomised controlled trial

Helena Igelström  1   2 , Pernilla Åsenlöf  3 , Margareta Emtner  3   4 , Eva Lindberg  4
Affiliations
Randomized Controlled Trial

Improvement in obstructive sleep apnea after a tailored behavioural sleep medicine intervention targeting healthy eating and physical activity: a randomised controlled trial

Helena Igelström et al. Sleep Breath. 2018 Sep.

Abstract

Purpose: The aim of the present single-centre randomised controlled trial was to assess the effect of a behavioural sleep medicine (BSM) intervention on obstructive sleep apnea (OSA) severity in patients who have been referred for new treatment with continuous positive airway pressure (CPAP).

Methods: After baseline assessment including ventilatory and anthropometric parameters, and physical activity monitoring, 86 patients who were overweight (BMI ≥ 25) and had moderate-severe OSA with apnea-hypopnea index (AHI) ≥ 15 were randomised into a control group (CG; CPAP and advice about weight loss) or an experimental group (ExpG; CPAP and BSM intervention targeting physical activity and eating behaviour). The BSM intervention comprised 10 individual sessions with a dietician and a physiotherapist and included behaviour change techniques such as goal setting and self-monitoring. After 6 months, a new recording of ventilatory parameters was performed without CPAP.

Results: In ExpG, 40% (n = 14) had improved from severe to moderate or mild OSA or from moderate to mild OSA compared to 16.7% in CG (n = 6, p = 0.02). Further, a lower AHI and amount body fat at baseline were correlated with improvement in severity class. Being in ExpG implied a mean improvement in AHI by 9.7 and an odds ratio of 4.5 for improving in severity classification.

Conclusions: The results highlight the clinical importance of lifestyle modifications in conjunction with CPAP treatment in patients with OSA.

Keywords: Behaviour modification; Diet; Obstructive sleep apnea; Physical activity.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research (local ethics committee in Uppsala, Sweden; dnr 2009/004) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Flow chart of study participation from recruitment to follow-up at 6 months
Fig. 2
Fig. 2
Number of participants in each study group having improved, deteriorated, or not changed at all in categorisation of obstructive sleep apnea (OSA) severity from baseline to follow-up at 6 months
See this image and copyright information in PMC

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