1. The Effects of Long-term CPAP on Weight Change in Patients With Comorbid OSA and Cardiovascular Disease
- Author
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Geraldo Lorenzi-Filho, Qiong Ou, Richard J. Woodman, Luciano F. Drager, Ferran Barbé, Save Investigators, Rui Chen, Michael Hlavac, Nigel McArdle, Baixin Chen, Xilong Zhang, Kelly A. Loffler, R. Doug McEvoy, Olga Mediano, Qian Wang, Yuanming Luo, Craig S. Anderson, and Sutapa Mukherjee
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Epworth Sleepiness Scale ,Weight change ,Sleep apnea ,Anthropometry ,Critical Care and Intensive Care Medicine ,medicine.disease ,respiratory tract diseases ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Apnea–hypopnea index ,Randomized controlled trial ,law ,Internal medicine ,Post-hoc analysis ,medicine ,030212 general & internal medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Weight gain - Abstract
Background Although recent evidence suggests that OSA treatment may cause weight gain, the long-term effects of CPAP on weight are not well established. Methods This study was a post hoc analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) study, a multicenter, randomized trial of CPAP plus standard care vs standard care alone in adults with a history of cardiac or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants. Results A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [–0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, –0.14 kg [–0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control subjects without CPAP (mean difference, 0.38 kg [95% CI, 0.04 to 0.73]; P = .031), there were no between-group differences in other anthropometric variables, nor were there any differences between female high CPAP adherers and matched control subjects. Conclusions Long-term CPAP use in patients with comorbid OSA and cardiovascular disease does not result in clinically significant weight change. Trial Registry ClinicalTrials.gov; No.: NCT00738179 ; URL: www.clinicaltrials.gov .
- Published
- 2019