Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea
Quan, S.F.; Budhiraja, R.; Clarke, D.P.; Goodwin, J.L.; Gottlieb, D.J.; Nichols, D.A.; Simon, R.D.; Smith, T.W.; Walsh, J.K.; Kushida, C.A.
Journal of Clinical Sleep Medicine Jcsm Official Publication of the American Academy of Sleep Medicine 9(10): 989-993
ISSN/ISBN: 1550-9389 PMID: 24127141 DOI: 10.5664/jcsm.3064
To determine the impact of continuous positive airway pressure (CPAP) on weight change in persons with obstructive sleep apnea (OSA). The Apnea Positive Pressure Long-term Efficacy Study (APPLES) was a 6-month, randomized, double-blinded sham-controlled multicenter clinical trial conducted at 5 sites in the United States. Of 1,105 participants with an apnea hypopnea index ≥ 10 events/ hour initially randomized, 812 had body weight measured at baseline and after 6 months of study. CPAP or Sham CPAP. Body weight, height, hours of CPAP or Sham CPAP use, Epworth Sleepiness Scale score. Participants randomized to CPAP gained 0.35 ± 5.01 kg, whereas those on Sham CPAP lost 0.70 ± 4.03 kg (mean ± SD, p = 0.001). Amount of weight gain with CPAP was related to hours of device adherence, with each hour per night of use predicting a 0.42 kg increase in weight. This association was not noted in the Sham CPAP group. CPAP participants who used their device ≥ 4 h per night on ≥ 70% of nights gained the most weight over 6 months in comparison to non-adherent CPAP participants (1.0 ± 5.3 vs. -0.3 ± 5.0 kg, p = 0.014). OSA patients using CPAP may gain a modest amount of weight with the greatest weight gain found in those most compliant with CPAP. A commentary on this article appears in this issue on page 995. Quan SF; Budhiraja R; Clarke DP; Goodwin JL; Gottlieb DJ; Nichols DA; Simon RD; Smith TW; Walsh JK; Kushida CA. Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea.