Sibutramineversuscontinuous positive airway pressure in obese obstructive sleep apnoea patients

Apr 10, 2009The European respiratory journal

Comparing weight-loss drug sibutramine and breathing support in obese patients with sleep apnea

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Abstract

Sibutramine treatment resulted in a 5.4 kg weight loss over one year in obese patients with obstructive sleep apnoea.

Sibutramine treatment did not improve sleep-disordered breathing or blood pressure.
Continuous positive airway pressure (CPAP) treatment improved all measured sleep and respiratory variables.
CPAP treatment reduced night-time systolic and diastolic blood pressure, while sibutramine had no effect.
Sibutramine had no impact on heart rate variability, whereas CPAP increased daytime heart rate variability indices.
No adverse effects, such as increased blood pressure or arrhythmias, were noted with either treatment.

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The aim of the present study was to compare the efficacy of 1 yr of sibutramine-induced weight loss versus continuous positive airway pressure (CPAP) treatment on sleep-disordered breathing, cardiac autonomic function and systemic blood pressure in obese patients with obstructive sleep apnoea. Subjects with a body mass index of > or =30 kg.m(-2) without previous treatment for obstructive sleep apnoea underwent either sibutramine (n = 22) or CPAP (n = 18) treatment for 1 yr. Sibutramine induced a 5.4+/-1.4 kg decrease in body weight compared to the CPAP group, in which no changes in anthropometric variables were observed. The CPAP treatment improved all sleep and respiratory variables, whereas sibutramine-induced weight loss improved only nocturnal arterial oxygen saturation profile. Only CPAP treatment improved night-time systolic and diastolic blood pressure and 24-h and daytime ambulatory diastolic blood pressure. Sibutramine-induced weight loss had no impact on indices of heart rate variability, whereas CPAP treatment increased daytime time domain indices. CPAP treatment for 1 yr had beneficial impacts on nocturnal breathing disturbances, and improved nocturnal oxygenation, night-time systolic and diastolic blood pressure, and daytime cardiac parasympathetic modulation. Sibutramine did not improve sleep-disordered breathing, systemic blood pressure or heart rate variability. There were no adverse effects, such as increment in blood pressure or arrhythmias, associated with this treatment regimen.

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Sibutramineversuscontinuous positive airway pressure in obese obstructive sleep apnoea patients

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