Predictors of weight loss in obese patients with obstructive sleep apnea

Thomas J Altree; Delwyn J Bartlett; Nathaniel S Marshall; Camilla M Hoyos; Craig L Phillips; Callum Birks; Aran Kanagaratnam; Anna Mullins; Yasmina Serinel; Keith K H Wong; Brendon J Yee; Ronald R Grunstein; Elizabeth A Cayanan

doi:10.1007/s11325-021-02455-4

Predictors of weight loss in obese patients with obstructive sleep apnea

Sleep Breath. 2022 Jun;26(2):753-762. doi: 10.1007/s11325-021-02455-4. Epub 2021 Aug 6.

Authors

Thomas J Altree^{1

2}, Delwyn J Bartlett^{3

4}, Nathaniel S Marshall^{3

5

6}, Camilla M Hoyos^{3

5

7

8}, Craig L Phillips^{3

4

9}, Callum Birks⁶, Aran Kanagaratnam⁴, Anna Mullins¹⁰, Yasmina Serinel^{3

11}, Keith K H Wong^{3

4

12}, Brendon J Yee^{3

4

12}, Ronald R Grunstein^{3

4

5}, Elizabeth A Cayanan^{3

5

6}

Affiliations

¹ CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia. thomas.altree@flinders.edu.au.
² Adelaide Institute for Sleep Health, Flinders University, Level 2, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, South Australia, 5049, Australia. thomas.altree@flinders.edu.au.
³ CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.
⁴ Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
⁵ NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia.
⁶ Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, Australia.
⁷ Faculty of Science, School of Psychology, The University of Sydney, Sydney, Australia.
⁸ Healthy Brain Ageing Program, Brain and Mind Centre, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
⁹ Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia.
¹⁰ Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine, New York, NY, USA.
¹¹ Department of Respiratory and Sleep Medicine, Nepean Hospital, Kingswood, Australia.
¹² Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

PMID: 34357505
DOI: 10.1007/s11325-021-02455-4

Abstract

Purpose: Consistent predictors of weight loss outcomes with very low-energy diets (VLEDs) in obstructive sleep apnea (OSA) have not been identified. This study aimed to identify variables predictive of weight loss success in obese patients with OSA undertaking an intensive weight loss programme.

Methods: We analysed biological, psychological, and behavioural variables as potential predictors of weight loss in obese patients with OSA after a 2-month VLED followed by one of two 10-month weight loss maintenance diets. Actigraphy, in-lab polysomnography, urinary catecholamines, and various psychological and behavioural variables were measured at baseline, 2, and 12 months. Spearman's correlations analysed baseline variables with 2-month weight loss, and 2-month variables with 2-12 month-weight change.

Results: Forty-two patients completed the VLED and thirty-eight completed the maintenance diets. Actigraphy data revealed that late bedtime (r_s = - 0.45, p = < 0.01) was correlated with 2-month weight loss. The change in the time that participants got out of bed (rise-time) from baseline to two months was also correlated with 2-month weight loss (r_s = 0.36, p = 0.03). The Impact of Weight on Quality of Life-Lite questionnaire (IWQOL) Public Distress domain (r_s = - 0.54, p = < 0.01) and total (r_s = - 0.38, p = 0.02) scores were correlated with weight loss maintenance from 2 to 12 months.

Conclusions: Results from this small patient sample reveal correlations between actigraphy characteristics and weight loss in obese patients with OSA. We suggest the IWQOL may also be a useful clinical tool to identify OSA patients at risk of weight regain after initial weight loss.

Clinical trial registration: This clinical trial was prospectively registered on 18/02/2013 with the Australia and New Zealand Clinical Trials Registry (ACTRN12613000191796).

Public registry title: Sleep, Lifestyle, Energy, Eating, Exercise Program for the management of sleep apnea patients indicated for weight loss treatment: A randomised, controlled pilot study. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363680.

Keywords: Actigraphy; Obesity; Obstructive sleep apnea; Very low-energy diet.

Publication types

Randomized Controlled Trial

MeSH terms

Humans
Obesity / complications
Polysomnography
Quality of Life*
Sleep Apnea, Obstructive* / diagnosis
Sleep Apnea, Obstructive* / therapy
Weight Loss