Relationship between energy expenditure, physical activity and weight loss during CPAP treatment in obese OSA subjects

Mar 15, 2015Respiratory medicine

How energy use, exercise, and weight loss relate during sleep apnea treatment in obese adults

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Abstract

Obese patients with obstructive sleep apnea exhibited an increase in daytime energy expenditure by 38 Kcal/day after 6 months of CPAP treatment.

Total energy expenditure (EE) was similar between obese OSA patients and healthy controls at baseline.
Obese OSA patients exhibited higher energy expenditure during the night compared to daytime energy expenditure in the control group.
In patients, energy expenditure correlated with the severity of obstructive sleep apnea and the degree of daytime sleepiness.
No significant changes in body mass index (BMI) or total energy expenditure occurred after CPAP treatment.
Only patients compliant with CPAP showed a decrease in nighttime energy expenditure and an increase in daytime energy expenditure.

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BACKGROUND: Increased energy expenditure (EE) has been reported in patients with obstructive sleep apnea (OSA). It has been postulated that CPAP treatment may induce weight reduction in obese patients, even if it has not been confirmed by recent studies. In the present study we investigated the effect of OSA on EE and the effect of CPAP on body weight and physical activity.

METHODS: One hundred and seven obese OSA patients and 25 healthy obese volunteers, as control group, matched for age, sex and BMI, were enrolled. The following evaluation was performed only in OSA patients after 6 months of CPAP treatment.

RESULTS: Baseline total EE was similar in the two groups, but OSA patients showed higher EE during the night, while control group during daytime. In patients, EE correlates with OSA severity, degree of daytime sleepiness or obesity. At follow-up evaluation, BMI and total EE were unchanged. However, daytime EE increased (1066 ± 131.5 vs 1104 ± 133 Kcal/die, p < 0.001, respectively) and night EE decreased (694 ± 69 vs 595 ± 73, p < 0.0001, respectively). Statistically significant changes in BMI, sleepiness scale, blood gases and EE were found only in patients who were compliant to CPAP.

CONCLUSIONS: Obese OSA patients showed an increased night EE that was normalized only in those patients compliant to CPAP. Body weight and daily physical activity did not change in statistically significant way.

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Relationship between energy expenditure, physical activity and weight loss during CPAP treatment in obese OSA subjects

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