Impact of Treatment with Continuous Positive Airway Pressure (CPAP) on Weight in Obstructive Sleep Apnea

Quan, Stuart F.; Budhiraja, Rohit; Clarke, Denise P.; Goodwin, James L.; Gottlieb, Daniel J.; Nichols, Deborah A.; Simon, Richard; Smith, T.; Walsh, James K.; Kushida, Clete A.

doi:10.5664/jcsm.3064

Cited by 94 publications

(82 citation statements)

References 31 publications

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“…1 Tal recurso tem tido ampla aplicação clínica nos últimos anos, como no edema pulmonar cardiogênico, na apneia obstrutiva do sono e em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). [2][3][4] O estudo da permeabilidade epitelial pulmonar é feito utilizando-se traçadores radioativos que, administrados sob a forma de aerosol, permitem a medida da sua taxa de depuração pulmonar através da detecção externa da radiação por cintigrafia. Rinderknecht et al (1977), introduziram a taxa de depuração pulmonar do radioaerossol de dietilenotriaminopentacético marcado com Tecnécio-99m ( 99m Tc-DTPA) como método para avaliar alterações na permeabilidade epitelial pulmonar e, por questões de adequação técnica, baixa dose de irradiação, não invasibilidade e comodidade para o paciente, a taxa de depuração de aerosóis de 99m Tc-DTPA foi adotada como método padrão para avaliação da permeabilidade do epitélio pulmonar.…”

Section: Introductionunclassified

Efeito De Diferentes Níveis De Pressão Positiva Continua Sobre a Depuração Pulmonar Do 99mtc-Dtpa

Paiva

Bordin

Gass

et al. 2014

Rev Epidemiol Control Infect

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O não produziu alteração na taxa de depuração. Backgound and Objectives:Positive airway pressure continues (CPAP) produces significant hemodynamic changes that may influence the variability of breathing pattern and heart rate, acting as an additional therapy to prevent atelectasis and to combat hypoxia. The rate of inhaled 99m Technetium-diethylenetriaminepentaacetic acid ( 99m Tc-DTPA), along with changes in the lung epithelium cause an increase in the rate of clearance of this compound. The aim of this study was evaluate the pulmonary clearance rate of 99m Technetium-Diethylenetriaminepentaacetic acid ( 99m Tc-DTPA) through the use of different levels of CPAP. Methods: It was a quasi-experimental study involving 17 healthy individuals with normal lung functional. Tc-DTPA clearance moreover, 10 cmH 2 O did not alter its clearance rate. RESUMO ABSTRACT

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Section: Introductionunclassified

Efeito De Diferentes Níveis De Pressão Positiva Continua Sobre a Depuração Pulmonar Do 99mtc-Dtpa

Paiva

Bordin

Gass

et al. 2014

Rev Epidemiol Control Infect

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“…103 [Level 2] However, most patients do not pursue weight loss and, in fact, a recent article suggested that many patients may gain weight after initiating CPAP. 104 [Level 3] At a minimum, all overweight or obese patients should be offered counseling about weight reduction.…”

Section: Opportunities For Improvement/gapsmentioning

confidence: 99%

Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea

Aurora

Collop

Jacobowitz

et al. 2015

Journal of Clinical Sleep Medicine

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“…Having previously observed a lack of weight loss in this cohort, 9 we hypothesized that diet and physical activity patterns do not change with CPAP treatment.…”

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confidence: 99%

“…Unfortunately, several studies, including results from two randomized controlled trials, demonstrate that CPAP by itself does not engender weight loss and may actually promote weight gain. [9][10][11][12][13][14][15] Changes in weight are a refl ection of net caloric balance: the difference between caloric expenditures and consumption. encouraged in obese patients with OSA, but it is unclear whether treatment with CPAP results in behavioral modifications.…”

mentioning

confidence: 99%

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

Batool-Anwar

Goodwin

Drescher

et al. 2014

Journal of Clinical Sleep Medicine

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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...

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Impact of Treatment with Continuous Positive Airway Pressure (CPAP) on Weight in Obstructive Sleep Apnea

Cited by 94 publications

References 31 publications

Efeito De Diferentes Níveis De Pressão Positiva Continua Sobre a Depuração Pulmonar Do 99mtc-Dtpa

Efeito De Diferentes Níveis De Pressão Positiva Continua Sobre a Depuração Pulmonar Do 99mtc-Dtpa

Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea

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

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