Weight reduction in patients with OSA and obesity was associated with AHI improvement, where a 20% BMI reduction correlated with a 57% AHI reduction.
Meta-Analysis
Does weight reduction improve the apnea-hypopnea index in people with obesity/overweight and obstructive sleep apnea?
Weight reduction significantly improves obstructive sleep apnea severity, with a 20% BMI reduction yielding a 57% decrease in the apnea-hypopnea index.
p-value: p=<0.05
Obstructive sleep apnea (OSA) is strongly associated with obesity. While the relationship between weight reduction and apnea-hypopnea index improvement has been documented, to our knowledge, it has not been quantified adequately. Therefore, this study aimed to quantify the relationship between weight reduction and AHI change. METHODS: A systematic literature search was performed using meta-analyses (PRISMA) guidelines for studies reporting AHI and weight loss in people with obesity/overweight and OSA between 2000 and 2023. A linear and quadratic model (weighted by treatment arm sample size) predicted percent change from baseline AHI against mean percent change from baseline weight. The quadratic term was statistically significant (P < 0.05), so the quadratic model (with 95 % prediction interval) was used. RESULTS: The literature search identified 27 studies/32 treatment arms: 15 using bariatric surgery and lifestyle intervention each and 2 using pharmacological interventions. Included studies were ≥3 months with weight intervention and participants had AHI ≥15/h. Weight reduction in people with OSA and obesity was associated with improvements in the severity of OSA. BMI reduction of 20 % was associated with AHI reduction of 57 %, while further weight reduction beyond 20 % in BMI was associated with a smaller effect on AHI. As the prediction intervals are relatively wide, a precise relationship could not be conclusively established. CONCLUSION: The degree of AHI index improvement was associated with the magnitude of weight reduction. The model suggests that with progress in weight reduction beyond 20 %, the incremental decrease in BMI appeared to translate to a smaller additional effect on AHI.
Malhotra et al. (Sat,) conducted a meta-analysis in Obstructive sleep apnea (OSA) and obesity/overweight. Weight reduction was evaluated on Percent change from baseline AHI against mean percent change from baseline weight (p=<0.05). Weight reduction in patients with OSA and obesity was associated with AHI improvement, where a 20% BMI reduction correlated with a 57% AHI reduction.