Weighing the Impact of CPAP Therapy on Body Mass in Persons With OSA

  • Rohit Budhiraja
    Affiliations
    Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, and the Division of Sleep Medicine, Harvard Medical School, Boston, MA
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  • Stuart F. Quan
    Correspondence
    CORRESPONDENCE TO: Stuart F. Quan, MD, Division of Sleep Medicine, Harvard Medical School, 164 Longwood Ave, Boston, MA 02115
    Affiliations
    Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, and the Division of Sleep Medicine, Harvard Medical School, Boston, MA
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      FOR RELATED ARTICLE, SEE PAGE 720
      Several studies have demonstrated that when used adequately, CPAP therapy mitigates several negative consequences of OSA, including excessive sleepiness and hypertension, and improves quality of life.
      • Budhiraja R.
      • Kushida C.A.
      • Nichols D.A.
      • et al.
      Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6 months of continuous positive airway pressure therapy.
      • Chowdhuri S.
      • Quan S.F.
      • Almeida F.
      • et al.
      An official American Thoracic Society research statement: impact of mild obstructive sleep apnea in adults.
      However, concerning is the observation by several researchers that use of CPAP has been associated with weight gain.
      • Quan S.F.
      • Budhiraja R.
      • Clarke D.P.
      • et al.
      Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea.
      • Drager L.F.
      • Brunoni A.R.
      • Jenner R.
      • Lorenzi-Filho G.
      • Benseñor I.M.
      • Lotufo P.A.
      Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials.
      This is a bothersome finding because increased weight is generally associated with the development or worsening of OSA and adverse health outcomes. Furthermore, a fear of weight gain might negatively influence the decision of patients with OSA to accept or be adherent to CPAP therapy.
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      References

        • Budhiraja R.
        • Kushida C.A.
        • Nichols D.A.
        • et al.
        Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6 months of continuous positive airway pressure therapy.
        Eur Respir J. 2017; 50
        • Chowdhuri S.
        • Quan S.F.
        • Almeida F.
        • et al.
        An official American Thoracic Society research statement: impact of mild obstructive sleep apnea in adults.
        Am J Respir Crit Care Med. 2016; 193: e37-e54
        • Quan S.F.
        • Budhiraja R.
        • Clarke D.P.
        • et al.
        Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea.
        J Clin Sleep Med. 2013; 9: 989-993
        • Drager L.F.
        • Brunoni A.R.
        • Jenner R.
        • Lorenzi-Filho G.
        • Benseñor I.M.
        • Lotufo P.A.
        Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials.
        Thorax. 2015; 70: 258-264
        • Ong C.W.
        • O’Driscoll D.M.
        • Truby H.
        • Naughton M.T.
        • Hamilton G.S.
        The reciprocal interaction between obesity and obstructive sleep apnoea.
        Sleep Med Rev. 2013; 17: 123-131
        • Patel S.R.
        • Palmer L.J.
        • Larkin E.K.
        • Jenny N.S.
        • White D.P.
        • Redline S.
        Relationship between obstructive sleep apnea and diurnal leptin rhythms.
        Sleep. 2004; 27: 235-239
        • Moreno-Indias I.
        • Torres M.
        • Montserrat J.M.
        • et al.
        Intermittent hypoxia alters gut microbiota diversity in a mouse model of sleep apnoea.
        Eur Respir J. 2015; 45: 1055-1065
        • Phillips B.
        • Dhaon N.A.
        Weigh the options before starting CPAP.
        J Clin Sleep Med. 2013; 9: 995-996
        • Tachikawa R.
        • Ikeda K.
        • Minami T.
        • et al.
        Changes in energy metabolism after continuous positive airway pressure for obstructive sleep apnea.
        Am J Respir Crit Care Med. 2016; 194: 729-738
        • Garcia J.M.
        • Sharafkhaneh H.
        • Hirshkowitz M.
        • Elkhatib R.
        • Sharafkhaneh A.
        Weight and metabolic effects of CPAP in obstructive sleep apnea patients with obesity.
        Respir Res. 2011; 12: 80
        • Münzer T.
        • Hegglin A.
        • Stannek T.
        • et al.
        Effects of long-term continuous positive airway pressure on body composition and IGF1.
        Eur J Endocrinol. 2010; 162: 695-704
        • Ou Q.
        • Chen B.
        • Loffler K.A.
        • et al.
        The effects of long-term CPAP on weight change in patients with comorbid OSA and cardiovascular disease: data from the SAVE trial.
        Chest. 2019; 155: 720-729
        • Lee R.W.
        • Vasudavan S.
        • Hui D.S.
        • et al.
        Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea.
        Sleep. 2010; 33: 1075-1080
        • Leong W.B.
        • Arora T.
        • Jenkinson D.
        • et al.
        The prevalence and severity of obstructive sleep apnea in severe obesity: the impact of ethnicity.
        J Clin Sleep Med. 2013; 9: 853-858
        • Budhiraja R.
        • Thomas R.
        • Kim M.
        • Redline S.
        The role of big data in the management of sleep-disordered breathing.
        Sleep Med Clin. 2016; 11: 241-255

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