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Weight Loss and Obstructive Sleep Apnea
Weight Reduction Using Very-Low-Calorie Diet Benefits Obstructive Sleep Apnea
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Very Low-Calorie Diet-Induced Weight Loss & Sleep Apnea

The aim of this study was to examine the effect of a very low-calorie diet (VLCD)-induced weight loss on the severity of obstructive sleep apnea (OSA), blood pressure and cardiac autonomic regulation in obese patients with obstructive sleep apnea syndrome (OSAS).

A total of 15 overweight patients (14 men and one woman, body weight 114 +/- 20 kg, age 52 +/- 9 years, range 39-67 years) with OSAS were studied prospectively. They were advised to follow a 2.51-3.35 MJ (600-800 kcal) diet daily for a 3-month period. In the beginning of the study, the patients underwent nocturnal sleep studies, autonomic function tests and 24-h electrocardiograph (ECG) recording. In addition, 15 age-matched, normal-weight subjects were studied. They underwent the Valsalva test, the deep-breathing test and assessment of heart rate variability at rest. The sleep studies and autonomic function tests were repeated after the weight loss period. There was a significant reduction in weight (114 +/- 20 kg to 105 +/- 21 kg, P < 0.001), the weight loss being 9.2 +/- 4.0 kg (range 2.3-19.5 kg). This was associated with a significant improvement in the oxygen desaturation index (ODI4) during sleep.

Before the weight loss the obstructive sleep apnea patients had significantly higher blood pressure, for systolic blood pressure, for diastolic blood pressure) and heart rate at rest than the control group. They had also lower baroreflex sensitivity. During the weight reduction, the blood pressure declined significantly, and the baroreflex sensitivity increased by 49 percent.

In conclusion, our experience shows that weight loss with VLCD is an effective treatment for obstructive sleep apnea. Weight loss improved significantly sleep apnoea and had favourable effects on blood pressure and baroreflex sensitivity that may have prognostic implications.

Source: Kansanen M, Vanninen E, Tuunainen A, Pesonen P, Tuononen V, Hartikainen J, Mussalo H, Uusitupa M. Department of Otolaryngology, Kuopio University Hospital, Finland.

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