Lifestyle Interventions in the Treatment of OSA

  1. Lifestyle interventions include dietary modification, behavioral therapy, and their combinations.
  2. Little data currently exist on the efficacy of weight loss via dietary management on OSA.
  3. Behavioral therapy refers to strategies that help set and achieve weight loss goals, manage stress, and improve healthy behaviors.
  4. Behavioral therapy is effective particularly when combined with additional strategies to loose weight, such as calorie restriction or medications.
  5. There are very few studies that report the impact of behavioral therapy alone on weight loss in patients with OSA.
  6. The Sleep AHEAD study showed a very modest average change in the AHI but nearly 40% of the subjects in the intervention arm improved the severity of OSA.
  7. Behavioral therapy seems to be most effective when used in conjunction with programs that incorporate VLCD (very low calorie diet).
  8. Exercise is considered a key component in weight loss programs.  It efficiently burns calories and, when combined with caloric restriction, weight loss can be achieved.
  9. Exercise may affect OSA by increasing the upper muscle tone, changing body fat distribution of body fat, and/or altering control of breathing and arousal.  The effect of exercise may be partially mediated by the change in weight but there also may be some protective effect independent of the weight loss.