The study randomised 260 overweight patients (average age 61) with type 2 diabetes and OSA (average apnea-hypopnea index (AHI), 23 events per hour) to an intensive lifestyle intervention using restricted caloric intake and moderate exercise, or to a series of three group sessions on diabetes management (control group).
At 1 year follow-up the intensive-intervention patients had lost significantly more weight (10.8 kg vs 0.6 kg; P < .001) and showed a significant improvement in sleep apnea.
Compared to the control group, they had an adjusted decrease in AHI of 9.7 (2.0) events per hour (P<.001). At 1 year, more than three times as many participants in this group had total remission of their OSA, and the prevalence of severe OSA was half that of the control group.
The greatest benefit was observed in men, in participants with more severe OSA at baseline, and in participants who lost the most weight.
The researchers said the increase in AHI over 1 year in participants who were weight stable suggests that OSA is a rapidly progressing syndrome that will worsen without treatment. However, they cautioned that the results should not be generalised to younger patients, to patients without type 2 diabetes, or to patients with milder degrees of OSA.
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