Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis
Summary Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis...
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Veröffentlicht in: | Obesity reviews 2019-05, Vol.20 (5), p.750-762 |
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description | Summary
Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea‐hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random‐effects models. The meta‐analyses of 13 randomized controlled trials and 22 uncontrolled before‐and‐after studies (1420 participants) revealed significant reductions on AHI (d = −0.61 and −0.46, respectively), ODI (d = −0.61 and −0.46) and EDS (d = −0.41 and −0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise‐training may be the most effective treatments for male patients with moderate‐severe OSA. |
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Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea‐hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random‐effects models. The meta‐analyses of 13 randomized controlled trials and 22 uncontrolled before‐and‐after studies (1420 participants) revealed significant reductions on AHI (d = −0.61 and −0.46, respectively), ODI (d = −0.61 and −0.46) and EDS (d = −0.41 and −0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise‐training may be the most effective treatments for male patients with moderate‐severe OSA.</description><identifier>ISSN: 1467-7881</identifier><identifier>EISSN: 1467-789X</identifier><identifier>DOI: 10.1111/obr.12824</identifier><identifier>PMID: 30609450</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adults ; Alcohols ; Apnea ; Body weight loss ; Clinical trials ; Desaturation ; Diet ; Humans ; Hygiene ; Life Style ; lifestyle intervention ; Lifestyles ; Meta-analysis ; Obesity - complications ; Obesity - therapy ; obstructive sleep apnoea ; Sleep ; Sleep and wakefulness ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - therapy ; Sleep deprivation ; Sleep disorders ; Sleepiness ; Systematic review ; Tobacco ; Training ; Treatment Outcome ; Weight Loss</subject><ispartof>Obesity reviews, 2019-05, Vol.20 (5), p.750-762</ispartof><rights>2019 World Obesity Federation</rights><rights>2019 World Obesity Federation.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4194-ed328b9690bd2f2c32551ed1a50e42d7405ad14aefb759240ad86394a4473e463</citedby><cites>FETCH-LOGICAL-c4194-ed328b9690bd2f2c32551ed1a50e42d7405ad14aefb759240ad86394a4473e463</cites><orcidid>0000-0002-3879-6468</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fobr.12824$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fobr.12824$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30609450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carneiro‐Barrera, Almudena</creatorcontrib><creatorcontrib>Díaz‐Román, Amparo</creatorcontrib><creatorcontrib>Guillén‐Riquelme, Alejandro</creatorcontrib><creatorcontrib>Buela‐Casal, Gualberto</creatorcontrib><title>Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis</title><title>Obesity reviews</title><addtitle>Obes Rev</addtitle><description>Summary
Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea‐hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random‐effects models. The meta‐analyses of 13 randomized controlled trials and 22 uncontrolled before‐and‐after studies (1420 participants) revealed significant reductions on AHI (d = −0.61 and −0.46, respectively), ODI (d = −0.61 and −0.46) and EDS (d = −0.41 and −0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise‐training may be the most effective treatments for male patients with moderate‐severe OSA.</description><subject>Adults</subject><subject>Alcohols</subject><subject>Apnea</subject><subject>Body weight loss</subject><subject>Clinical trials</subject><subject>Desaturation</subject><subject>Diet</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Life Style</subject><subject>lifestyle intervention</subject><subject>Lifestyles</subject><subject>Meta-analysis</subject><subject>Obesity - complications</subject><subject>Obesity - therapy</subject><subject>obstructive sleep apnoea</subject><subject>Sleep</subject><subject>Sleep and wakefulness</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - therapy</subject><subject>Sleep deprivation</subject><subject>Sleep disorders</subject><subject>Sleepiness</subject><subject>Systematic review</subject><subject>Tobacco</subject><subject>Training</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>1467-7881</issn><issn>1467-789X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10ctKxDAUBuAgiveFLyABN7oYJ0nTS9ypeANB8ILuStqcaiRtxiQd6c5H8Bl9EjOOuhDM5mTx8ZOcH6EtSvZpPGNbuX3KCsYX0CrlWT7KC_Gw-Hsv6Apa8_6ZEJqLhC6jlYRkRPCUrKL-HvTjU8DGeo9lp7DRDfgwGMC6C-Cm0AVtO48b67CtfHB9HfQUsDcAEywnnQUZKZaqN8Ef4JvBB2hl0DV2MNXw-pXaQpAfb--yk2bw2m-gpUYaD5vfcx3dnZ7cHp-PLq_OLo4PL0c1p4KPQCWsqEQmSKVYw-qEpSkFRWVKgDOVc5JKRbmEpspTwTiRqsgSwSXneQI8S9bR7jx34uxLH_9VttrXYIzswPa-ZDTjlKSEFZHu_KHPtnfxvVExwijNmJipvbmqXVyYg6acON1KN5SUlLMuythF-dVFtNvfiX3VgvqVP8uPYDwHr9rA8H9SeXV0PY_8BDTFlQ0</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Carneiro‐Barrera, Almudena</creator><creator>Díaz‐Román, Amparo</creator><creator>Guillén‐Riquelme, Alejandro</creator><creator>Buela‐Casal, Gualberto</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TS</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3879-6468</orcidid></search><sort><creationdate>201905</creationdate><title>Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis</title><author>Carneiro‐Barrera, Almudena ; Díaz‐Román, Amparo ; Guillén‐Riquelme, Alejandro ; Buela‐Casal, Gualberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4194-ed328b9690bd2f2c32551ed1a50e42d7405ad14aefb759240ad86394a4473e463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adults</topic><topic>Alcohols</topic><topic>Apnea</topic><topic>Body weight loss</topic><topic>Clinical trials</topic><topic>Desaturation</topic><topic>Diet</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Life Style</topic><topic>lifestyle intervention</topic><topic>Lifestyles</topic><topic>Meta-analysis</topic><topic>Obesity - complications</topic><topic>Obesity - therapy</topic><topic>obstructive sleep apnoea</topic><topic>Sleep</topic><topic>Sleep and wakefulness</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - therapy</topic><topic>Sleep deprivation</topic><topic>Sleep disorders</topic><topic>Sleepiness</topic><topic>Systematic review</topic><topic>Tobacco</topic><topic>Training</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carneiro‐Barrera, Almudena</creatorcontrib><creatorcontrib>Díaz‐Román, Amparo</creatorcontrib><creatorcontrib>Guillén‐Riquelme, Alejandro</creatorcontrib><creatorcontrib>Buela‐Casal, Gualberto</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Physical Education Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carneiro‐Barrera, Almudena</au><au>Díaz‐Román, Amparo</au><au>Guillén‐Riquelme, Alejandro</au><au>Buela‐Casal, Gualberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis</atitle><jtitle>Obesity reviews</jtitle><addtitle>Obes Rev</addtitle><date>2019-05</date><risdate>2019</risdate><volume>20</volume><issue>5</issue><spage>750</spage><epage>762</epage><pages>750-762</pages><issn>1467-7881</issn><eissn>1467-789X</eissn><abstract>Summary
Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea‐hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random‐effects models. The meta‐analyses of 13 randomized controlled trials and 22 uncontrolled before‐and‐after studies (1420 participants) revealed significant reductions on AHI (d = −0.61 and −0.46, respectively), ODI (d = −0.61 and −0.46) and EDS (d = −0.41 and −0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise‐training may be the most effective treatments for male patients with moderate‐severe OSA.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30609450</pmid><doi>10.1111/obr.12824</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-3879-6468</orcidid></addata></record> |
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subjects | Adults Alcohols Apnea Body weight loss Clinical trials Desaturation Diet Humans Hygiene Life Style lifestyle intervention Lifestyles Meta-analysis Obesity - complications Obesity - therapy obstructive sleep apnoea Sleep Sleep and wakefulness Sleep apnea Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - therapy Sleep deprivation Sleep disorders Sleepiness Systematic review Tobacco Training Treatment Outcome Weight Loss |
title | Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis |
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