Abstract
Background: Obesity is a major, modifiable risk factor for obstructive sleep apnoea (OSA). Given the relative ineffectiveness of usual care (UC) for weight loss, we tested, at 3 and 6 months, the effects of a Chronic Condition Management Program (CCMP) designed to enhance patient self-management and goal setting for weight loss in obese patients with moderate-severe OSA. Methods: We recruited 40 patients at our sleep centre meeting the inclusion criteria: age 18–70 years, apnoea-hypopnoea index (AHI) ≥20 events/h, body mass index (BMI) ≥30 and Epworth Sleepiness Scale (ESS) score ≥8. The CCMP was delivered to all participants. Patients were offered the option of a 6-month meal replacement program as part of the CCMP. Change in BMI at 3 months was compared in the first 19 of 40 CCMP OSA patients with 41 historical OSA controls who were given usual care (UC) i.e. standard advice on weight loss by their sleep physicians. The potential change in BMI caused by a patient getting either CCMP or UC was calculated using inverse probability weights and conditioning on covariates age, sex and baseline BMI. Questionnaires were completed at baseline and 6 months including the ESS, Assessment of Quality of Life (AQoL-4D) scale, Hospital Anxiety and Depression Scale and Patient Assessment of Chronic Illness Care scale.
Progress to date: Baseline measures for CCMP (n = 19) and control (n = 41) participants were 47% cf. 76% males, mean age 49.4 cf. 53 years, BMI 37.3 cf. 33.9 and AHI 55.3 cf. 46.3. We calculated that at 3-month follow-up, the average BMI if all 60 participants were to receive CCMP would be 2.1 points less than the average of 36.1 that would occur if none of the participants had received CCMP (95% CI: 3.4 to 0.84; P = 0.001). Interpreted as a
percentage, the average BMI falls by an estimated 5.9% when every participant receives CCMP relative to the case of every participant under UC conditions (95% CI: 2.4% to 9.3% reduction). To date, 6-month measures have been performed in 8 participants.
Intended outcome and impact: These preliminary results suggest that a structured CCMP that includes a meal replacement option is likely to be more effective than standard advice for weight loss in OSA. We intend to compare the sustainability of weight loss at 6 months in the whole study population and measure the impacts of the CCMP on subjective sleepiness and psychosocial parameters.
Progress to date: Baseline measures for CCMP (n = 19) and control (n = 41) participants were 47% cf. 76% males, mean age 49.4 cf. 53 years, BMI 37.3 cf. 33.9 and AHI 55.3 cf. 46.3. We calculated that at 3-month follow-up, the average BMI if all 60 participants were to receive CCMP would be 2.1 points less than the average of 36.1 that would occur if none of the participants had received CCMP (95% CI: 3.4 to 0.84; P = 0.001). Interpreted as a
percentage, the average BMI falls by an estimated 5.9% when every participant receives CCMP relative to the case of every participant under UC conditions (95% CI: 2.4% to 9.3% reduction). To date, 6-month measures have been performed in 8 participants.
Intended outcome and impact: These preliminary results suggest that a structured CCMP that includes a meal replacement option is likely to be more effective than standard advice for weight loss in OSA. We intend to compare the sustainability of weight loss at 6 months in the whole study population and measure the impacts of the CCMP on subjective sleepiness and psychosocial parameters.
| Original language | English |
|---|---|
| Article number | 060 |
| Pages (from-to) | 21 |
| Number of pages | 1 |
| Journal | Journal of Sleep Research |
| Volume | 25 |
| Issue number | S2 |
| DOIs | |
| Publication status | Published - 11 Oct 2016 |
| Event | 28th ASM of Australasian Sleep Association and Australasian Sleep Technologists Association - Duration: 20 Oct 2017 → … |
