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An eight-week interdisciplinary program based on the weight loss and lifestyle changes has managed to cure sleep apnea. This has been achieved by a team of researchers from the University of Granada and the Virgen de las Nieves Hospital in Granada, thus demonstrating that obstructive sleep apnea (OSA) it is not a chronic disease as was thought and that can remit in 62% of cases.
The results of the Interapnea study (Interdisciplinary Weight Loss and Lifestyle Intervention for Obstructive Sleep Apnea) have been published in the prestigious medical journal JAMA Network Open, one of the most important in the world.
An eight-week interdisciplinary treatment for weight loss and lifestyle changes -including nutritional education, physical exercise, quitting tobacco and alcohol consumption and sleep hygiene- has proven to be effective in improving not only severity of OSA (reduction of 23.8 apneas-hypopneas/hour), weight (6.9 kg loss) and fat mass (6.5 kg loss) and cardiometabolic comorbidities, but also daily functioning and psychiatric symptomatology, physical fitness, dietary behavior and, consequently, quality of life.
Repetitive breathing obstructions during sleep cause chronic exposure to bouts of hypoxia, hypercapnia, increased sympathetic activity, oxidative stress, and systemic inflammation. Due to these pathophysiological responses, OSA is associated with hypertension, dyslipidemia, diabetes, cardiovascular disease, and increased mortality from all causes.
OSA is a major public health problem due not only to its high prevalence (affecting up to one billion adults worldwide, 38% of the general adult population), but also to its wide spectrum of clinical and socioeconomic consequences. . This sleep-disordered breathing is characterized by recurrent collapse of the upper airways during sleep, and obesity is the main attributable cause.
Currently, continuous positive airway pressure (CPAP) is the standard treatment for this disease. It is a machine in which un tube that connects to a mask or nosepiece to supply a constant and stable air pressure that helps the patient to breathe while sleeping.
However, CPAP is a chronic daily treatment, adherence rates are poor, and long-term benefits beyond reduction in airway obstruction remain uncertain.
In contrast, weight loss through alternative or combined behavioral interventions appears to substantially improve OSA severity and comorbidities in adults with moderate-severe OSA.
In fact, to the six month follow-upthere was a 57% reduction in the number of apneas-hypopneas and 62% of patients were discharged and were able to stop using CPAP to sleep.
The findings of this study have important clinical and public health relevance in the area of sleep medicine, because they demonstrate that OSA is not a chronic disease and convey a simple but essential message: an interdisciplinary treatment for weight loss and lifestyle changes should be the standard treatment for OSA.
The results of the Interapnea study represent a firm advance in the investigation and treatment of this increasingly prevalent sleep-disordered breathing.
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