Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention
Open accessAbstract
Objective To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.Patients and methods Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity.Results At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA.Conclusion Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling.
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Patients with obstructive sleep apnea lose less weight than their peers.
“Patients with OSA lose less weight than their peers, even though studies suggest that patients with OSA may demonstrate greater engagement with lifestyle-based weight management programs.7,8”
From Receipt of Glucagon-Like Peptide-1 Receptor Agonists Among Rural Patients with Obstructive Sleep Apnea and Excess Weight (2026) · cites this paper as [7]
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- Authors
- Kline, C. E., Burke, L. E., Sereika, S. M., Imes, C. C., Rockette-Wagner, B., Mendez, D. D., Strollo, P. J., Zheng, Y., Rathbun, S. L., & Chasens, E. R.
- Affiliations
- University of Pittsburgh (US)
- Boston College (US)
- University of Georgia (US)
- Corresponding author
- Kline, Christopher E.
- ORCID
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 93
- Issue
- 9
- Pages
- 1290-1298
- ISSN
- 0025-6196 (ISSN-L)
- PMC
- PMC6129208
- OpenAlex
- W2885031393
- Cited by
- 30
- References
- 38
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 1 · 2019: 2
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01HL107370, R01HL107370-S1, K24NR016685, K23HL118318)
- Agency for Healthcare Research and Quality (K12HS022989)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obstructive sleep apnea, weight change, behavioral weight loss, apnea-hypopnea index, bidirectional relationship, obesity, overweight adults, physical activity, sleep apnea screening
- MeSH terms
- Adult, Aged, Female, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Weight Loss, Linear Models, Treatment Outcome, Sleep Apnea, Obstructive, Overweight, Weight Reduction Programs
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