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. 2021 Feb 17;8(1):1888394.
doi: 10.1080/20018525.2021.1888394.

Mood, sleepiness, and weight gain after three years on CPAP therapy for sleep apnoea

Miia M Aro  1   2   3 , Ulla Anttalainen  1   2   3 , Olli Polo  4 , Tarja Saaresranta  1   2   3
Affiliations

Mood, sleepiness, and weight gain after three years on CPAP therapy for sleep apnoea

Miia M Aro et al. Eur Clin Respir J. .

Abstract

Background: The prevalence of obstructive sleep apnoea syndrome (OSAS) keeps on rising. Daytime sleepiness resulting from fragmented sleep is the prime symptom, and obesity the major risk factor for OSAS. Quality of life with OSAS is often affected by depressive symptoms and anxiety. Nasal continuous positive airway pressure (CPAP) therapy reduces daytime sleepiness, but the results on the effect on mood, physical activity, and weight are controversial especially on long-term therapy. Purpose of this study was to evaluate these factors and predictors of weight gain during long-term CPAP therapy. Methods: Consecutive patients (n = 223), referred to sleep study with suspected OSAS, were enrolled. Patients underwent a cardiorespiratory polygraphy at baseline and a battery of questionnaires was completed, both at baseline, and after three years of follow-up. Total of 149 (67%; M 65, F 84) patients completed the follow-up. Of the 149 patients, 76 (51.0%; M 32, F 44) used CPAP. Results: In this study, depressive symptoms, anxiety, and sleepiness were alleviated during CPAP therapy. However, therapy did not have an influence on cravings of different food categories, or exercise habits and exercise duration. From the various factors studied, solely higher adherence to CPAP therapy was associated with weight gain. Conclusions: This research provides further evidence that long-term CPAP therapy in patients with OSAS not only decreases sleepiness and improves sleep quality but could also alleviate depressive symptoms and anxiety. In addition, our study reinforces that CPAP therapy alone is not sufficient for weight management in patients with OSAS. Regardless of comprehensive battery of questionnaires, we were unable to establish markers predicting weight gain during therapy. We advise on life-style counselling and weight management program to all patients with obesity on CPAP therapy.

Keywords: CPAP; Sleep apnoea; anxiety; cravings; depression; exercise; lifestyle; sleepiness; weight.

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Conflict of interest statement

Dr. Aro reports participation in international scientific conferences sponsored by Boehringer-Ingelheim and Takeda. Dr. Anttalainen reports personal Fees paid for lectures from the Finnish Medical Association, ResMed Finland, Roche, Mundipharma and Fisher & Paykel. Participation for the international scientific conferences sponsored by Boehringer-Ingelheim and Roche. Member of the Finnish Current Care Task Force for Adult obstructive sleep apnoea and employed by the Turku University Hospital. Dr Polo has no conflicts of interest. Dr. Saaresranta reports speaking fees from Medical Association of Duodecim, City of Turku, Association of Finnish Respiratory Physicians, ResMed Finland, Boehringer Ingelheim, Mundiphrama, Chiesi and AGA Health Care, registration fee, hotel and travel costs to participate in international scientific congresses paid in full or partly by European Respiratory Society, Nordic Lung Congress 2017 and 2019, Roche, Boehringer Ingelheim, and Chiesi. President of the Task Force for Finnish Current Care Guidelines of Adult OSA. No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Formation of patient groups. From the original baseline cohort (n = 223), 74 patients did not participate in follow-up study three years later, when patients were divided into two groups (CPAP users or non-users). CPAP users had used CPAP device regularly over four hours per day for three years, and those who discontinued therapy before the three-year follow-up point, were treated as non-users, leaving 76 CPAP users and 73 non-users to final analysis
See this image and copyright information in PMC

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