Impact of CPAP on Activity Patterns and Diet in Patients with Obstructive Sleep Apnea (OSA)

Abstract

However, there are few studies that have demonstrated the effect of OSA treatment on energy consumption and physical activity. 16,17 Such information is vital, given that both obesity and OSA are independent risk factors for poor health and increased cardiovascular morbidity and mortality. Moreover, lifestyle modifi cations involving diet and physical activity are Study Objectives: Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Effi cacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Methods: Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Results: Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m 2 , and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep effi ciency (p < 0.05). The BMI was higher among women in both CPAP and Sham groups. However, compared to women, men had higher AHI only in the CPAP group (50 vs. 34). Similarly, the arousal index was higher among men in CPAP group. Level of adherence defi ned as hours of device usage per night at 4 months was signifi cantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p < 0.05), there also were no changes in activity patterns. S C I E N T I F I C I N V E S T I G A T I O N SO besity is considered a strong risk factor for the development and progression of obstructive sleep apnea (OSA). 1Continuous positive airway pressure (CPAP) is considered the gold standard for OSA treatment and has been shown to improve daytime sleepiness, quality of life, and depressive symptoms, as well as reduce risk for cardiovascular disease and mortality.2-7 Despite these benefi ts, CPAP treatment is not considered curative and its success depends on compliance, which remains a major challenge.8 Thus, overweight patients are encouraged to lose weight with goal of reducing or eliminating the need for CPAP if suffi cient weight loss is achieved. Moreover, t...

Effects of continuous positive airway pressure on energy balance regulation: a systematic review

“…Several studies also described relevant secondary outcomes, and therefore had data that were included in other categories. Specifically, the one study included in the energy intake category also contained data on physical activity [47]. One of the studies in the indirect calorimetry category also contained data on energy intake, hormones and physical activity [48].…”

Effects of continuous positive airway pressure on energy intake in obstructive sleep apnea: A pilot sham-controlled study

“…Increased liking for high-fat foods [12] and preference for calorie-rich foods high in fat and carbohydrate [13] were observed in association with OSA severity. Batool-Anwar et al investigated the effects of continuous positive airway pressure (CPAP) on food intake in OSA patients using a Food Frequency Questionnaire (FFQ), and found that CPAP treatment reduced consumption of trans-fat in women, but did not affect overall EI [14]. However, some authors suggest that subjective tools like the FFQ may in fact lead to inaccurate conclusions, including a systematic underestimation of actual EI, and their use should be abandoned [15].…”

Among Metabolic Factors, Significance of Fasting and Postprandial Increases in Acyl and Desacyl Ghrelin and the Acyl/Desacyl Ratio in Obstructive Sleep Apnea before and after Treatment

“…40 Our data may support their data. Thus, preserved dietary habits due to ghrelin-related factors in this study in addition to a decrease in energy expenditure in OSA patients following CPAP treatment might cause body weight gain 41 or make it difficult to lose body weight during CPAP treatment. 21 This study had some limitations.…”