S126 Developing Healthy Lifestyle Interventions For Overweight Patients With Obstructive Sleep Apnoea (osa): A Survey Of Patient Attitudes And Current Practice

Abstract

Background Weight loss and improving cardiorespiratory fitness are key treatment outcomes for obese individuals with Obstructive Sleep Apnoea (OSA). We investigated the total energy expenditure and cardiorespiratory response to weight supported (cycling) and unsupported (walking) at two different intensities. Methods Individuals with treated OSA and a BMI >30 kg/m 2 performed an incremental cardiopulmonary exercise test on a cycle ergometer (ICE) and a treadmill (ITM) with expired gas analysis to determine the peak oxygen uptake (VO 2 pk). Participants completed two endurance tests on each modality matched at 80% and 60% of the highest VO 2 pk determined by the incremental tests. The cardiorespiratory responses were measured and total energy expenditure was estimated from the VO 2 . , respectively. Participants endured treadmill walking at 80% and 60% VO 2 pk for four and nearly three times as long, respectively, compared to cycling with similar cardiovascular responses. The pattern of energy expenditure during rest, exercise and recovery at matched intensities ( Figure 1) was similar between modalities at matched intensities.Total energy expenditure during treadmill walking was greater than cycling at both high (158[101] Methods A questionnaire was developed to assess patients' experience with lifestyle changes, their preferences and willingness to take part in a healthy lifestyle intervention, and their internet and IT usage. This was administered to patients with treated OSAS attending a sleep clinic. The MRC dyspnoea scale grade and Veterans Specific Activity Questionnaire (VSAQ)(1) were measured. Current practice regarding lifestyle advice and interventions, and serial weights were assessed by a case-note review of sequential overweight patients with treated OSAS attending a sleep clinic.Results 112 patients with treated OSAS completed the survey (results shown in [3][4][5][6][7] indicating being unable to walk briskly. 75% of individuals had access to broadband Internet (Table 1) and over 40% would be interested in a web-based healthy lifestyle intervention. 33 case-notes were reviewed with a mean follow up of 5 years. 27/33 individuals had been given healthy lifestyle advice of which 24/27 was to lose weight. Only two individuals had been recommended to join a leisure programme. Weight remained unchanged over five years after diagnosis, ANOVA p = 0.90. Conclusions Breathlessness causing reduced physical activity was commonly reported in overweight patients with OSAS. Weight loss is not currently achieved after simple advice from a healthcare professional, and advice or support regarding increasing physical activity is rarely provided. Further support with healthy lifestyle interventions should be explored, and attitudes and Internet access would favour development of a web-based intervention.