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.
Key Words
Abbreviations:
AHI ( apnea-hypopnea index), CV ( cardiovascular), ESS ( Epworth Sleepiness Scale), ODI ( oxygen desaturation index)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: September 27, 2018
Footnotes
FUNDING/SUPPORT: The Sleep Apnea Cardiovascular Endpoints (SAVE) trial was funded by project grants [1006501 and 1060078] from the National Health and Medical Research Council of Australia and by the Respironics Sleep and Respiratory Research Foundation and Philips Respironics. Supplementary funding was provided by Fisher & Paykel Healthcare and the Australasian Sleep Trials Network [enabling grant 343020 from the National Health and Medical Research Council]. In-kind donations were provided by Respironics for the CPAP equipment and by ResMed for the sleep apnea diagnostic devices. This substudy was supported by a grant [National Natural Science Foundation of China 81870077] to Q. O.
Dr Mukherjee is currently with the Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia; and the Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, SA, Australia.
Identification
Copyright
© 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
