A new guideline focused on the role of weight management in treating adult obstructive sleep apnea (OSA) has been published online by an international panel assembled by the American Thoracic Society in the Sept. 15 American Journal of Respiratory and Critical Care Medicine.
The guideline demonstrates that weight loss provides a distinct benefit to OSA patients and expands the content of previous clinical practice guidelines by offering specific recommendations for weight loss and discussing the evidence for each recommendation. In addition to these scientifically derived recommendations, the guideline reviews and discusses successful methods for practitioners to discuss weight issues and ways to interact with patients who are overweight or obese.
OSA is a common disease that occurs when the upper airway becomes blocked repeatedly during sleep, reducing or stopping airflow. Being overweight or obese is a strong risk factor for OSA, and weight loss can often reduce the severity of OSA.
The guideline panel reviewed scores of studies and rated the strength of study findings, along with the certainty of the panel’s recommendations, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system.
The panel also noted that weight loss, either through lifestyle changes or bariatric surgery, has benefits beyond reducing OSA severity. Among those benefits are prevention of type 2 diabetes, improved glycemic control in those with type 2 diabetes, lower blood pressure and improved quality of life.
In formulating its recommendations, the panel reviewed studies that found patients are often unaware that they are overweight or obese and that clinicians are often reluctant to discuss the need for weight loss or give patients a diagnosis of obesity. Even when the need for weight loss is discussed, the panel said, an effective weight loss program is often not initiated.
Sleep researcher, Docent Henri Tuomilehto of the University of Eastern Finland was one of the 20 members of the guideline panel led by Professor David W. Hudgel.
According to Dr. Tuomilehto, the guideline is a welcome step in increasing awareness and offering practical tools for the treatment of sleep apnea patients. His research group at the University of eastern Finland was the first in the world to show the benefits of weight loss to overweight sleep apnea patients in a randomised lifestyle intervention in 2009.
Development of the guideline was funded by the American Thoracic Society.
For further information, please contact:
Henri Tuomilehto, tel. +358 40 5945068, henri.tuomilehto@oivauni.fi
The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline. David W. Hudgel, Sanjay R. Patel, Amy M. Ahasic, Susan J. Bartlett, Daniel H. Bessesen, Melisa A. Coaker, P. Michelle Fiander, Ronald R. Grunstein, Indira Gurubhagavatula, Vishesh K. Kapur, Christopher J. Lettieri, Matthew T. Naughton, Robert L. Owens, Jean-Louis D. Pepin, Henri Tuomilehto, Kevin C. Wilson, on behalf of the American Thoracic Society Assembly on Sleep and Respiratory Neurobiology. American Journal of Respiratory and Critical Care Medicine, Vol. 198, No. 6, Sep 15, 2018. https://doi.org/10.1164/rccm.201807-1326ST
Contact for Guideline:
David W. Hudgel, MD, hudgeldavid@yahoo.com