Sleeping Well Trial: Increasing the effectiveness of treatment with continuous positive airway pressure using a weight management program in overweight adults with obstructive sleep apnoea-A stepped wedge randomised trial protocol

Nutr Diet. 2019 Feb;76(1):110-117. doi: 10.1111/1747-0080.12435. Epub 2018 May 24.

Abstract

Background: The majority of adults diagnosed with obstructive sleep apnoea (OSA) are overweight or obese. Continuous positive airway pressure (CPAP) is the most common effective therapy for OSA. However, adherence declines over time with only 50% of patients prescribed CPAP continuing to use it long term. Furthermore, a recent prospective analysis indicated that those more adherent with CPAP therapy have enhanced weight gain trajectories which in turn may negatively impact their OSA.

Aim: The Sleeping Well Trial aims to establish whether the timing of starting a lifestyle weight loss intervention impacts on weight trajectory in those with moderate-severe OSA treated at home with CPAP, while testing the potential for smart phone technology to improve adherence with lifestyle interventions.

Methods: A stepped wedge design with randomisation of individuals from 1 to 6 months post-enrolment, with 5 months of additional prospective follow up after completion of the stepped wedge. This design will investigate the effect of the 6-month lifestyle intervention on people undergoing CPAP on body weight, body composition and health-related quality of life.

Discussion: This trial tests whether the timing of supporting the patient through a weight loss intervention is important in obtaining the maximum benefit of a lifestyle change and CPAP usage, and identify how best to support patients through this critical period.

Trial registration: The protocol (v1) is registered prospectively with the International Clinical Trials Registry (CTR) ACTRN12616000203459 (public access). Any amendments to protocol will be documented via the CTR. Recruitment commenced in March 2016 with data collection scheduled to finish by May 2018.

Keywords: modified fasting; obesity; obstructive sleep apnoea; weight management.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Weight
  • Continuous Positive Airway Pressure / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Nutrition Therapy
  • Obesity
  • Overweight*
  • Prospective Studies
  • Quality of Life
  • Sleep / physiology*
  • Sleep Apnea, Obstructive / therapy*
  • Weight Reduction Programs / methods*
  • Young Adult

Associated data

  • ANZCTR/ACTRN12616000203459