Lifestyle-related weight gain in obese men with newly diagnosed obstructive sleep apnea

Patients with obstructive sleep apnea (OSA) are frequently obese and are predisposed to weight gain. They also have heightened sympathetic drive. We reasoned that noradrenergic activation of β3-receptors on adipocytes would inhibit leptin production, predisposing to obesity in sleep apnea. We therefore tested the hypothesis that obesity and predisposition to weight gain in OSA are associated with low levels of plasma leptin. We prospectively studied 32 male patients (43 ± 2 yr) with OSA who were newly diagnosed and never treated and who were free of any other diseases. Control measurements were obtained from 32 similarly obese closely matched male subjects (38 ± 2 yr). Leptin levels were 13.7 ± 1.3 and 9.2 ± 1.2 ng/ml in patients with OSA and controls, respectively ( P = 0.02). Weight gain over the year before diagnosis was 5.2 ± 1.7 and 0.5 ± 0.9 kg in sleep apnea patients and similarly obese control subjects, respectively ( P = 0.04). Muscle sympathetic activity was 46 ± 4 and 30 ± 4 bursts/min in patients with OSA ( n = 16) and control subjects ( n = 18), respectively ( P = 0.01). Plasma leptin levels are elevated in newly diagnosed otherwise healthy patients with untreated sleep apnea beyond the levels seen in similarly obese control subjects without sleep apnea. Higher leptin levels in OSA, independent of body fat content, suggest that OSA is associated with resistance to the weight-reducing effects of leptin.

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Rationale and design of remotely-supervised cardiac rehabilitation study in patients with obstructive sleep apnea

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.207 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

J Hnatiak ◽

O Ludka ◽

L Batalik ◽

P Winnige ◽

F Dosbaba

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cardiac Rehabilitation ◽

Public Institution ◽

Moderate Intensity ◽

Newly Diagnosed ◽

Cpap Therapy ◽

Phone Calls ◽

Obstructive Sleep ◽

Home Conditions

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Ministry of Health Czech Republic; identification of organization 65269705 Background Although continuous positive airway pressure (CPAP) is currently still the gold standard for therapy of moderate to severe obstructive sleep apnea (OSA), another alternative or adjunct effective therapeutic options exist. Lifestyle intervention focused on nutrition and weight reduction, regular exercise, sleep hygiene, smoking and alcohol restriction represents a recommended therapeutic strategy for OSA. Though this intervention represents an effective tool for improving objective and subjective parameters of OSA, it’s effectivity depends on components of the intervention, OSA severity and gender. Comprehensive remotely-supervised cardiac rehabilitation (CR) represents possible training intervention in home conditions using elements of telemedicine. Purpose This prospective study aims to investigate the feasibility and effect of a remotely-supervised CR in patients with newly diagnosed OSA with Apnea-Hypopnea Index greater than 15 episodes per hour. Methods This monocentric study is designed as a prospective, parallel, randomised, controlled trial of remotely-supervised 12-week CR in male patients between 40-60 years old with newly diagnosed OSA indicated to CPAP therapy. The sample size is calculated by 0,05 level of significance and 80% statistical power on 25 participants in each group. The Intervention group will undergo comprehensive remotely-supervised CR in home conditions with teleconsultation (contains telecoaching, telemonitoring) via regular phone calls and e-mails at least 1-2 times a week. The intervention will include nutrition, health-related lifestyle and behavioral changes recommendations, and at least 5 times a week 30 minutes of moderate-intensity aerobic training, 10 minutes of inspiratory and expiratory muscle training with breathing device and 10 minutes of oropharyngeal exercise along with individually titrated CPAP therapy. The control group will undergo individually titrated CPAP therapy only. The participants in both groups will go through the following assessments before and after this study: polysomnography, spirometry, anthropometry and body composition examination, laboratory values examination, quality of life questionnaires, Epworth sleepiness scale, 6-min walking test. Conclusions: Comprehensive remotely-supervised CR, as mentioned in this study, may represent an adjunct therapy with a promising future in patients with OSA. The study is occupied with a current issue and can also bring new possibilities and experiences in remote rehabilitation.

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Brain putamen volume changes in newly-diagnosed patients with obstructive sleep apnea

NeuroImage Clinical ◽

10.1016/j.nicl.2014.01.009 ◽

2014 ◽

Vol 4 ◽

pp. 383-391 ◽

Cited By ~ 29

Author(s):

Rajesh Kumar ◽

Salar Farahvar ◽

Jennifer A. Ogren ◽

Paul M. Macey ◽

Paul M. Thompson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Newly Diagnosed ◽

Volume Changes ◽

Obstructive Sleep

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P.083 THE INCREMENTAL EFFECT OF OBSTRUCTIVE SLEEP APNEA SYNDROME ON ARTERIAL STIFFNESS IN NEWLY DIAGNOSED ESSENTIAL HYPERTENSIVE SUBJECTS

Artery Research ◽

10.1016/s1872-9312(07)70106-0 ◽

2007 ◽

Vol 1 (S1) ◽

pp. S47

Author(s):

K. Thomopoulos* ◽

C. Tsioufis ◽

A. Amfilochiou ◽

E. Vezali ◽

M. Alchanatis ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Arterial Stiffness ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Newly Diagnosed ◽

Incremental Effect ◽

Obstructive Sleep ◽

Apnea Syndrome

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0632 The Correlation Between Severity of Obstructive Sleep Apnea and Patient Compliance

SLEEP ◽

10.1093/sleep/zsaa056.628 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A241-A241

Author(s):

A C Roberts ◽

G Bastin

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Patient Compliance ◽

Compliance Rate ◽

Newly Diagnosed ◽

Cpap Therapy ◽

Cpap Adherence ◽

Obstructive Sleep ◽

Significant Difference ◽

Cpap Compliance

Abstract Introduction Obstructive sleep apnea (OSA) is a prevalent disorder affecting 9-38% of the global population and is linked to multiple health complications. Continuous Positive Airway Pressure (CPAP) is regarded as the gold standard treatment for OSA, but its efficacy is limited by poor patient compliance. Studies have linked many clinical and lifestyle factors to CPAP adherence, but have produced conflicting outcomes. Based on the current literature, it is assumed patients diagnosed with severe OSA are more likely to be compliant with CPAP due to a greater improvement in quality of life. The goal of this study is to compare the compliance rate of CPAP for patients with mild, moderate, and severe OSA, as well as identify other potential predictors of CPAP compliance. Methods This study is a retrospective chart review of 100 patients who were newly diagnosed with OSA and started on CPAP between January 1, 2017 and January 1, 2018. Baseline demographic data, past medical history, OSA severity, Epworth sleepiness scale, and compliance to CPAP therapy were recorded. Compliance was defined as CPAP usage greater than four hours per night for at least 21 days per month. Results Mean follow-up time after CPAP initiation was 3.19 months. Overall 77% of patients were compliant to CPAP therapy, of which 48% were males and 52% were females (P=0.48). CPAP compliance rates for mild OSA (79.3%), moderate OSA (73.7%), and severe OSA (78.8%) showed no significant difference for independence (P=0.83) or correlation with compliance (P=0.99). Only seasonal allergic rhinitis showed a positive association with CPAP adherence (P=0.031) and depression showed a negative association (P=0.027). Conclusion The level of OSA severity is not a significant predictor of short-term CPAP compliance among newly diagnosed patients. Support Parkview Physicians Group, Indiana School of Medicine - Fort Wayne, and the Dr. Luis and Anne B Schneider Foundation.

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