The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline
Open accessAbstract
Background: Overweight/obesity is a common, reversible risk factor for obstructive sleep apnea severity (OSA). The purpose of this guideline is to provide evidence-based recommendations for the management of overweight/obesity in patients with OSA. Methods: The Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the literature. Clinical recommendations were formulated by a panel of pulmonary, sleep medicine, weight management, and behavioral science specialists. Results: Behavioral, pharmacological, and surgical treatments promote weight loss and can reduce OSA severity, reverse common comorbidities, and improve quality of life, although published studies have methodological limitations. After considering the quality of evidence, feasibility, and acceptability of these interventions, the panel made a strong recommendation that patients with OSA who are overweight or obese be treated with comprehensive lifestyle intervention consisting of 1) a reduced-calorie diet, 2) exercise or increased physical activity, and 3) behavioral guidance. Conditional recommendations were made regarding reduced-calorie diet and exercise/increased physical activity as separate management tools. Pharmacological therapy and bariatric surgery are appropriate for selected patients who require further assistance with weight loss. Conclusions: Weight-loss interventions, especially comprehensive lifestyle interventions, are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life. The American Thoracic Society recommends that clinicians regularly assess weight and incorporate weight management strategies that are tailored to individual patient preferences into the routine treatment of adult patients with OSA who are overweight or obese.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Excess adiposity is a major reversible etiologic risk factor for obstructive sleep apnea and its complications.
“Excess adiposity is a major reversible etiologic risk factor for obstructive sleep apnea and its complications. 8,9”
From Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (2024) · cites this paper as [8]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
GRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285 · see citing works
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629 · see citing works
Bariatric Surgery: A Systematic Review and Meta-analysis
Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., & Schoelles, K. (2004) · JAMA · doi:10.1001/jama.292.14.1724 · Cited by 6,800 · see citing works
Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine, Epstein, L. J., Kristo, D., Strollo, P. J., Friedman, N., Malhotra, A., Patil, S. P., Ramar, K., Rogers, R., Schwab, R. J., et al. (2009) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27497 · Cited by 3,360 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735 · see citing works
A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management
Pi-Sunyer, X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., Lau, D. C. W., le Roux, C. W., Violante Ortiz, R., Jensen, C. B., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1411892 · Cited by 2,724 · see citing works
Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes
Schauer, P. R., Kashyap, S. R., Wolski, K., Brethauer, S. A., Kirwan, J. P., Pothier, C. E., Thomas, S., Abood, B., Nissen, S. E., & Bhatt, D. L. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1200225 · Cited by 2,164 · see citing works
XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study
Torgerson, J. S., Hauptman, J., Boldrin, M. N., & Sjöström, L. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.155 · Cited by 1,915 · see citing works
Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914 · see citing works
Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes
Mingrone, G., Panunzi, S., De Gaetano, A., Guidone, C., Iaconelli, A., Leccesi, L., Nanni, G., Pomp, A., Castagneto, M., Ghirlanda, G., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1200111 · Cited by 1,791 · see citing works
Dixon, J. B., O’Brien, P. E., Playfair, J., Chapman, L., Schachter, L. M., Skinner, S., Proietto, J., Bailey, M., & Anderson, M. (2008) · JAMA · doi:10.1001/jama.299.3.316 · Cited by 1,434 · see citing works
Andrews, J., Guyatt, G., Oxman, A. D., Alderson, P., Dahm, P., Falck-Ytter, Y., Nasser, M., Meerpohl, J., Post, P. N., Kunz, R., et al. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.03.013 · Cited by 1,416 · see citing works
Sjöström, L., Rissanen, A., Andersen, T., Boldrin, M., Golay, A., Koppeschaar, H. P., & Krempf, M. (1998) · The Lancet · doi:10.1016/s0140-6736(97)11509-4 · Cited by 1,237 · see citing works
Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., Andreasen, A. H., Jensen, C. B., DeFronzo, R. A., & for the NN8022-1922 Study Group (2015) · JAMA · doi:10.1001/jama.2015.9676 · Cited by 1,198 · see citing works
Astrup, A., Rössner, S., Van Gaal, L., Rissanen, A., Niskanen, L., Al Hakim, M., Madsen, J., Rasmussen, M. F., & Lean, M. E. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61375-1 · Cited by 1,163 · see citing works
Picot, J., Jones, J., Colquitt, J., Gospodarevskaya, E., Loveman, E., Baxter, L., & Clegg, A. (2009) · Health Technology Assessment · doi:10.3310/hta13410 · Cited by 1,066 · see citing works
Gadde, K. M., Allison, D. B., Ryan, D. H., Peterson, C. A., Troupin, B., Schwiers, M. L., & Day, W. W. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60205-5 · Cited by 1,064 · see citing works
Evaluating primary care behavioral counseling interventions An evidence-based approach
Whitlock, E. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00415-4 · Cited by 1,057 · see citing works
Greenway, F. L., Fujioka, K., Plodkowski, R. A., Mudaliar, S., Guttadauria, M., Erickson, J., Kim, D. D., & Dunayevich, E. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60888-4 · Cited by 1,036 · see citing works
Davidson, M. H., Hauptman, J., DiGirolamo, M., Foreyt, J. P., Halsted, C. H., Heber, D., Heimburger, D. C., Lucas, C. P., Robbins, D. C., Chung, J., et al. (1999) · JAMA · doi:10.1001/jama.281.3.235 · Cited by 947 · see citing works
Multicenter, placebo-controlled trial of lorcaserin for weight management.
Smith, S. R., Weissman, N. J., Anderson, C. M., Sanchez, M., Chuang, E., Stubbe, S., Bays, H., & Shanahan, W. R. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0909809 · Cited by 911 · see citing works
on behalf of the NN8022-1923 Investigators, Wadden, T. A., Hollander, P., Klein, S., Niswender, K., Woo, V, Hale, P. M., & Aronne, L. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.120 · Cited by 842 · see citing works
Rimm, E. B., Stampfer, M. J., Giovannucci, E. L., Ascherio, A., Spiegelman, D. L., Colditz, G. A., & Willett, W. C. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117385 · Cited by 840 · see citing works
(1998) · Obesity Research · doi:10.1002/j.1550-8528.1998.tb00690.x · Cited by 758 · see citing works
(2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30162-0 · Cited by 738 · see citing works
Ikramuddin, S., Korner, J., Lee, W.-J., Connett, J. E., Inabnet, W. B., Billington, C. J., Thomas, A. J., Leslie, D. B., Chong, K., Jeffery, R. W., et al. (2013) · JAMA · doi:10.1001/jama.2013.5835 · Cited by 735 · see citing works
Apovian, C. M., Aronne, L., Rubino, D., Still, C., Wyatt, H., Burns, C., Kim, D., Dunayevich, E., & for the COR‐II Study Group (2013) · Obesity · doi:10.1002/oby.20309 · Cited by 720 · see citing works
Allison, D. B., Gadde, K. M., Garvey, W. T., Peterson, C. A., Schwiers, M. L., Najarian, T., Tam, P. Y., Troupin, B., & Day, W. W. (2012) · Obesity · doi:10.1038/oby.2011.330 · Cited by 711 · see citing works
Hollander, P. A., Elbein, S. C., Hirsch, I. B., Kelley, D., McGill, J., Taylor, T., Weiss, S. R., Crockett, S. E., Kaplan, R. A., Comstock, J., et al. (1998) · Diabetes Care · doi:10.2337/diacare.21.8.1288 · Cited by 654 · see citing works
on behalf of the SCALE study group, Blackman, A., Foster, G. D., Zammit, G., Rosenberg, R., Aronne, L., Wadden, T., Claudius, B., Jensen, C. B., & Mignot, E. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.52 · Cited by 583 · see citing works
Schünemann, H. J., Jaeschke, R., Cook, D. J., Bria, W. F., El-Solh, A. A., Ernst, A., Fahy, B. F., Gould, M. K., Horan, K. L., Krishnan, J. A., et al. (2006) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200602-197st · Cited by 577 · see citing works
Fidler, M. C., Sanchez, M., Raether, B., Weissman, N. J., Smith, S. R., Shanahan, W. R., & Anderson, C. M. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1256 · Cited by 561 · see citing works
Wadden, T. A., Foreyt, J. P., Foster, G. D., Hill, J. O., Klein, S., O'Neil, P. M., Perri, M. G., Pi‐Sunyer, F. X., Rock, C. L., Erickson, J. S., et al. (2011) · Obesity · doi:10.1038/oby.2010.147 · Cited by 558 · see citing works
Efficacy of Brief Behavioral Treatment for Chronic Insomnia in Older Adults
Buysse, D. J., Germain, A., Moul, D. E., Franzen, P. L., Brar, L. K., Fletcher, M. E., Begley, A. E., Houck, P. R., Mazumdar, S., Reynolds, C. F., et al. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.535 · Cited by 552 · see citing works
(DPS), F. T. F. D. P. S., Lindström, J., Peltonen, M., Eriksson, J. G., Ilanne-Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., Uusitupa, M., & Tuomilehto, J. (2013) · Diabetologia · doi:10.1007/s00125-012-2752-5 · Cited by 551 · see citing works
Foster, G. D. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.266 · Cited by 538 · see citing works
O'Neil, P. M., Smith, S. R., Weissman, N. J., Fidler, M. C., Sanchez, M., Zhang, J., Raether, B., Anderson, C. M., & Shanahan, W. R. (2012) · Obesity · doi:10.1038/oby.2012.66 · Cited by 528 · see citing works
CPAP, Weight Loss, or Both for Obstructive Sleep Apnea
Chirinos, J. A., Gurubhagavatula, I., Teff, K., Rader, D. J., Wadden, T. A., Townsend, R., Foster, G. D., Maislin, G., Saif, H., Broderick, P., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1306187 · Cited by 523 · see citing works
Self-citationJohns, D. J., Hartmann‐Boyce, J., Jebb, S. A., & Aveyard, P. N. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2014.07.005 · Cited by 522 · see citing works
Wu, T., Gao, X., Chen, M., & Van Dam, R. M. (2009) · Obesity Reviews · doi:10.1111/j.1467-789x.2008.00547.x · Cited by 515 · see citing works
Hollander, P., Gupta, A. K., Plodkowski, R., Greenway, F., Bays, H., Burns, C., Klassen, P., Fujioka, K., & for the COR-Diabetes Study Group (2013) · Diabetes Care · doi:10.2337/dc13-0234 · Cited by 501 · see citing works
Weight Loss in Mildly to Moderately Obese Patients with Obstructive Sleep Apnea
Smith, P. L., Gold, A. R., Meyers, D. A., Haponik, E. F., & Bleecker, E. R. (1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-103-6-850 · Cited by 478 · see citing works
Effect of Weight Loss on Upper Airway Collapsibility in Obstructive Sleep Apnea
Schwartz, A. R., Gold, A. R., Schubert, N., Stryzak, A., Wise, R. A., Permutt, S., & Smith, P. L. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/144.3_pt_1.494 · Cited by 477 · see citing works
Rössner, S., Sjöström, L., Noack, R., Meinders, A. E., Noseda, G., & Study, O. B. O. T. E. O. O. (2000) · Obesity Research · doi:10.1038/oby.2000.8 · Cited by 476 · see citing works
Neve, M., Morgan, P. J., Jones, P. R., & Collins, C. E. (2010) · Obesity Reviews · doi:10.1111/j.1467-789x.2009.00646.x · Cited by 459 · see citing works
Lifestyle Intervention with Weight Reduction: First-line Treatment in Mild Obstructive Sleep Apnea
Tuomilehto, H., Seppä, J., Partinen, M., Peltonen, M., Gylling, H., Tuomilehto, J., Vanninen, E. J., Kokkarinen, J. I., Sahlman, J., Martikainen, T., et al. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200805-669oc · Cited by 438 · see citing works
Self-citationOrlistat in the long-term treatment of obesity in primary care settings.
Hauptman, J. (2000) · Archives of Family Medicine · doi:10.1001/archfami.9.2.160 · Cited by 367 · see citing works
Jolly, K., Lewis, A., Beach, J., Denley, J., Adab, P., Deeks, J. J., Daley, A., & Aveyard, P. (2011) · BMJ · doi:10.1136/bmj.d6500 · Cited by 359 · see citing works
Kline, C. E., Crowley, E., Ewing, G. B., Burch, J. B., Blair, S. N., Durstine, J. L., Davis, J. M., & Youngstedt, S. D. (2011) · SLEEP · doi:10.5665/sleep.1422 · Cited by 358 · see citing works
Qaseem, A., Humphrey, L. L., Fitterman, N., Starkey, M., & Shekelle, P. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-159-11-201312030-00009 · Cited by 329 · see citing works
Efficacy of Commercial Weight-Loss Programs: An Updated Systematic Review
Gudzune, K. A., Doshi, R. S., Mehta, A. K., Chaudhry, Z. W., Jacobs, D. K., Vakil, R. M., Lee, C. J., Bleich, S. N., & Clark, J. M. (2015) · Annals of Internal Medicine · doi:10.7326/m14-2238 · Cited by 325 · see citing works
Finer, N., James, W. P. T., Kopelman, P. G., Lean, M., & Williams, G. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801128 · Cited by 324 · see citing works
Mechanick, J. I., Hurley, D. L., & Garvey, W. T. (2017) · Endocrine Practice · doi:10.4158/ep161688.ps · Cited by 320 · see citing works
Kelley, D. E., Bray, G. A., Pi-Sunyer, F. X., Klein, S., Hill, J., Miles, J., & Hollander, P. (2002) · Diabetes Care · doi:10.2337/diacare.25.6.1033 · Cited by 314 · see citing works
Dixon, J. B., Schachter, L. M., O’Brien, P. E., Jones, K., Grima, M., Lambert, G., Brown, W., Bailey, M., & Naughton, M. T. (2012) · JAMA · doi:10.1001/2012.jama.11580 · Cited by 310 · see citing works
Self-citationPractice Parameters for the Medical Therapy of Obstructive Sleep Apnea
Standards of Practice Committee of the American Academy of Sleep Medicine, Morgenthaler, T. I., Kapen, S., Lee-Chiong, T., Alessi, C., Boehlecke, B., Brown, T., Coleman, J., Friedman, L., Kapur, V., et al. (2006) · Sleep · doi:10.1093/sleep/29.8.1031 · Cited by 299 · see citing works
Self-citationScreening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial
Aveyard, P. N., Lewis, A. L., Tearne, S., Hood, K., Christian-Brown, A., Adab, P., Begh, R. A., Jolly, K. B., Daley, A., Farley, A., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31893-1 · Cited by 298 · see citing works
Johansson, K., Neovius, M., Lagerros, Y. T., Harlid, R., Rössner, S., Granath, F. N., & Hemmingsson, E. (2009) · BMJ · doi:10.1136/bmj.b4609 · Cited by 293 · see citing works
Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study.
Hill, J. O., Hauptman, J., Anderson, J. W., Fujioka, K., O'Neil, P. M., Smith, D. K., Zavoral, J. H., & Aronne, L. J. (1999) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.6.1108 · Cited by 287 · see citing works
Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin
Miles, J. M., Leiter, L., Hollander, P., Wadden, T., Anderson, J. W., Doyle, M., Foreyt, J., Aronne, L., & Klein, S. (2002) · Diabetes Care · doi:10.2337/diacare.25.7.1123 · Cited by 286 · see citing works
Nissen, S. E., Wolski, K. E., Prcela, L., Wadden, T., Buse, J. B., Bakris, G., Perez, A., & Smith, S. R. (2016) · JAMA · doi:10.1001/jama.2016.1558 · Cited by 273 · see citing works
Williamson, D. A. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.544 · Cited by 244 · see citing works
Halperin, F., Ding, S.-A., Simonson, D. C., Panosian, J., GOEBEL-FABBRI, A. E., Wewalka, M., Hamdy, O., Abrahamson, M. J., Clancy, K. A., Foster, K., et al. (2014) · JAMA Surgery · doi:10.1001/jamasurg.2014.514 · Cited by 241 · see citing works
Kuna, S. T., Reboussin, D. M., Borradaile, K. E., Sanders, M. H., Millman, R. P., Zammit, G., Newman, A. B., Wadden, T. A., Jakicic, J. M., Wing, R. R., et al. (2013) · Sleep · doi:10.5665/sleep.2618 · Cited by 231 · see citing works
Surgical vs Medical Treatments for Type 2 Diabetes Mellitus
Courcoulas, A. P., Goodpaster, B. H., Eagleton, J. K., Belle, S. H., Kalarchian, M. A., Lang, W., Toledo, F. G. S., & Jakicic, J. M. (2014) · JAMA Surgery · doi:10.1001/jamasurg.2014.467 · Cited by 224 · see citing works
Dharmasena, S., & Capps, O. (2011) · Health Economics · doi:10.1002/hec.1738 · Cited by 224 · see citing works
Rose, S. A., Poynter, P. S., Anderson, J. W., Noar, S. M., & Conigliaro, J. C. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.24 · Cited by 220 · see citing works
Liang, Z., Wu, Q., Chen, B., Yu, P., Zhao, H., & Ouyang, X. (2013) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2013.04.005 · Cited by 206 · see citing works
Aerobic exercise and resting blood pressure: a meta-analytic review of randomized, controlled trials
Kelley, G. A., Kelley, K. A., & Vu Tran, Z. (2001) · Preventive Cardiology · doi:10.1111/j.1520-037x.2001.00529.x · Cited by 205 · see citing works
Lindgärde, F. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00720.x · Cited by 203 · see citing works
The Impact of Obesity on Oxygen Desaturation during Sleep-disordered Breathing
Peppard, P. E., Ward, N. R., & Morrell, M. J. (2009) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200905-0773oc · Cited by 194 · see citing works
The effect of exercise on obstructive sleep apnea: a randomized and controlled trial
Şengül, Y. S., Özalevli, S., Öztura, İ., İtil, O., & Baklan, B. (2009) · Sleep And Breathing · doi:10.1007/s11325-009-0311-1 · Cited by 183 · see citing works
Fleetham, J. A., Ayas, N., Bradley, D., Ferguson, K., Fitzpatrick, M., George, C., Hanly, P. J., Hill, F., Kimoff, J. R., Kryger, M. H., et al. (2006) · Canadian Respiratory Journal · doi:10.1155/2006/627096 · Cited by 166 · see citing works
Winslow, D. H., Bowden, C. H., DiDonato, K. P., & McCullough, P. A. (2012) · Sleep · doi:10.5665/sleep.2204 · Cited by 163 · see citing works
Hanefeld, M., & Sachse, G. (2002) · Diabetes, Obesity and Metabolism · doi:10.1046/j.1463-1326.2002.00237.x · Cited by 151 · see citing works
Reis, L. O., Fávaro, W. J., Barreiro, G. C., de Oliveira, L. C., Chaim, É. A., Fregonesi, A., & Ferreira, U. (2009) · International Journal of Andrology · doi:10.1111/j.1365-2605.2009.01017.x · Cited by 151 · see citing works
Richelsen, B., Tonstad, S., Rössner, S., Toubro, S., NISKANEN, L. K., Madsbad, S., Mustajoki, P., & Rissanen, A. (2006) · Diabetes Care · doi:10.2337/dc06-0210 · Cited by 147 · see citing works
Wentworth, J. M., Playfair, J., Laurie, C., Ritchie, M. E., Brown, W. A., Burton, P., Shaw, J. E., & O'Brien, P. E. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70066-x · Cited by 144 · see citing works
Efficacy and tolerability of orlistat in the treatment of obesity: a 6-month dose-ranging study
van Gaal, L. V., Broom, J., Enzi, G., & Toplak, H. (1998) · European Journal of Clinical Pharmacology · doi:10.1007/s002280050433 · Cited by 142 · see citing works
Mendelson, M., Lyons, O. D., Yadollahi, A., Inami, T., OH, P. I., & Bradley, T. D. (2016) · European Respiratory Journal · doi:10.1183/13993003.01897-2015 · Cited by 136 · see citing works
Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea
Aurora, R. N., Collop, N. A., Jacobowitz, O., Thomas, S. M., Quan, S. F., & Aronsky, A. J. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4556 · Cited by 135 · see citing works
Parikh, M., Chung, M., Sheth, S., McMacken, M., Zahra, T., Saunders, J. K., Ude-Welcome, A., Dunn, V., Ogedegbe, G., Schmidt, A. M., et al. (2014) · Annals of Surgery · doi:10.1097/sla.0000000000000919 · Cited by 123 · see citing works
Volger, S., Vetter, M. L., Dougherty, M., Panigrahi, E., Egner, R., Webb, V., Thomas, J. G., Sarwer, D. B., & Wadden, T. A. (2011) · Obesity · doi:10.1038/oby.2011.217 · Cited by 122 · see citing works
Predictors of longitudinal change in sleep-disordered breathing in a nonclinic population
Redline, S., Schluchter, M. D., Larkin, E. K., & Tishler, P. V. (2003) · Sleep · doi:10.1093/sleep/26.6.703 · Cited by 115 · see citing works
Berne, C., & the Orlistat Swedish Type 2 diabetes Study Group (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01474.x · Cited by 112 · see citing works
Broom, J. I., Wilding, J. P. H., Stott, P., Myers, N., & UK Multimorhidity Study Group (2002) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2002.tb11307.x · Cited by 103 · see citing works
The impact of physician weight discussion on weight loss in US adults
Pool, A. C., Kraschnewski, J. L., Cover, L., Lehman, E. B., Stuckey, H. L., Hwang, K. O., Pollak, K. I., & Sciamanna, C. (2013) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2013.03.003 · Cited by 97 · see citing works
Bakris, G. L., Calhoun, D. A., Egan, B. M., Hellmann, C. P., Dolker, M., & Kingma, I. (2002) · Journal of Hypertension · doi:10.1097/00004872-200211000-00026 · Cited by 96 · see citing works
Risk factors for hypertension in a national cohort study.
Ford, E. S., & Cooper, R. (1991) · Hypertension · doi:10.1161/01.hyp.18.5.598 · Cited by 90 · see citing works
Mingrone, G., Greco, A., Giancaterini, A., Scarfone, A., Castagneto, M., & Pugeat, M. (2002) · Atherosclerosis · doi:10.1016/s0021-9150(01)00667-0 · Cited by 89 · see citing works
Weight reduction and long-term maintenance after 18 months treatment with orlistat for obesity
Krempf, M., Jp, L., Allanic, H., Miloradovich, T., Joubert, J., & Attali, J. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802281 · Cited by 89 · see citing works
Servantes, D. M., Pelcerman, A., Salvetti, X. M., Salles, A. F., de Albuquerque, P. F., de Salles, F. C. A., Lopes, C., de Mello, M. T., Almeida, D. R., & Filho, J. A. O. (2011) · Clinical Rehabilitation · doi:10.1177/0269215511403941 · Cited by 87 · see citing works
Effect of orlistat on cardiovascular disease risk in obese adults
Swinburn, B. A., Carey, D., Hills, A. P., Hooper, M., Marks, S., Proietto, J., Strauss, B. J., Sullivan, D., Welborn, T. A., & Caterson, I. D. (2005) · Diabetes, Obesity and Metabolism · doi:10.1111/j.1463-1326.2004.00467.x · Cited by 81 · see citing works
Desplan, M., Mercier, J. G., Sabaté, M., Ninot, G., Prefaut, C., & Dauvilliers, Y. A. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.09.023 · Cited by 77 · see citing works
Weight reduction in osteoarthritis using phentermine.
Willims, R. A., & Foulsham, B. M. (1981) · PubMed · Cited by 75 · see citing works
Factors Influencing Primary Care Physicians' Referral for Bariatric Surgery
Tork, S., Meister, K. M., Uebele, A., Hussain, L. R., Kelley, S. R., Kerlakian, G., & Tymitz, K. M. (2015) · JSLS Journal of the Society of Laparoscopic & Robotic Surgeons · doi:10.4293/jsls.2015.00046 · Cited by 75 · see citing works
Ackel-D’Elia, C., da Silva, A. C., Silva, R. S., Truksinas, E., Sousa, B. S., Tufik, S. B., de Mello, M. T., & Bittencourt, L. (2011) · Sleep And Breathing · doi:10.1007/s11325-011-0567-0 · Cited by 74 · see citing works
Derosa, G., Mugellini, A., Ciccarelli, L., & Fogari, R. (2003) · Clinical Therapeutics · doi:10.1016/s0149-2918(03)80070-x · Cited by 71 · see citing works
Physical fitness and blood pressure
Fagard, R. H. (1993) · Journal of Hypertension · doi:10.1097/00004872-199312050-00008 · Cited by 70 · see citing works
Svendsen, M., Blomhoff, R., Holme, I., & Tonstad, S. (2007) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602652 · Cited by 67 · see citing works
A Randomized Controlled Study to Examine the Effect of a Lifestyle Modification Program in OSA
Ng, S. S. S., Chan, R. S. M., Woo, J., Chan, T.-O., Cheung, B. H. K., Sea, M. M. M., To, K.-W., Chan, K. K. P., Ngai, J., Yip, W.-H., et al. (2015) · Chest · doi:10.1378/chest.14-3016 · Cited by 62 · see citing works
Simpson, S. A., McNamara, R. L., Shaw, C., Kelson, M. J., Moriarty, Y., Randell, E., Cohen, D. R., Alam, M. F., Copeland, L., Duncan, D., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19500 · Cited by 58 · see citing works
Schutz, T. C., Cunha, T. C. A., Guimarães, T. M., Luz, G. C. P., Ackel-D’Elia, C., Alves, E. D. S., Pantiga, G., de Mello, M. T., Tufik, S. B., & Bittencourt, L. (2013) · Clinics · doi:10.6061/clinics/2013(08)17 · Cited by 57 · see citing works
Parthasarathy, S., Carskadon, M. A., Jean‐Louis, G., Owens, J. A., Bramoweth, A. D., Combs, D., Hale, L. E., Harrison, E. M., Hart, C. N., Hasler, B. P., et al. (2016) · SLEEP · doi:10.5665/sleep.6300 · Cited by 57 · see citing works
Motivational Interviewing in Internet Groups: A Pilot Study for Weight Loss
Webber, K., Tate, D. F., & Quintiliani, L. M. (2008) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.03.005 · Cited by 55 · see citing works
What do physicians recommend to their overweight and obese patients?
Phelan, S., Nallari, M., Darroch, F. E., & Wing, R. R. (2009) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2009.02.080081 · Cited by 54 · see citing works
Feigel-Guiller, B., Drui, D., Dimet, J., Zaïr, Y., Bras, M. L., Zamorano, N. F., Cariou, B., Letessier, E., Nobécourt, E., & Krempf, M. (2015) · Obesity Surgery · doi:10.1007/s11695-015-1627-5 · Cited by 51 · see citing works
Kj, L., Forbes, J. A., Gw, B., & Gf, G. (1974) · PubMed · Cited by 46 · see citing works
Poston, W. S. C., Haddock, C. K., Pinkston, M. M., Pace, P. W., Reeves, R. S., Karakoc, N. D., Jones, P., & Foreyt, J. P. (2006) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2006.01702.x · Cited by 46 · see citing works
O'Brien, P. E., Dixon, J. B., Laurie, C., Skinner, S., Proietto, J., McNeil, J., Strauss, B., Marks, S., Schachter, L., Chapman, L., et al. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-9-200605020-00005 · Cited by 46 · see citing works
Bakker, J. P., Tavakkoli, A., Rueschman, M., Wang, W., Andrews, R. A. F., Malhotra, A., Owens, R. L., Anand, A., Dudley, K. A., & Patel, S. R. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201708-1637le · Cited by 46 · see citing works
Self-citationEffects of orlistat on obesity‐related diseases – a six‐month randomized trial
Guy-grand, B., Drouin, P., Eschwège, É., Gin, H., Joubert, J., & Valensi, P. E. (2004) · Diabetes Obesity and Metabolism · doi:10.1111/j.1462-8902.2004.00359.x · Cited by 44 · see citing works
Collins, C. E., Morgan, P. J., Hutchesson, M., & Callister, R. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2626 · Cited by 38 · see citing works
A controlled trial of phentermine in obese diabetic patients.
Campbell, C. J., Bhalla, I. P., Jm, S., & Duncan, L. J. P. (1977) · PubMed · Cited by 37 · see citing works
Comparison of orlistat treatment and placebo in obese type 2 diabetic patients
Derosa, G., Maffioli, P., SALVADEO, S. A. T., Ferrari, I., Gravina, A., Mereu, R., D’Angelo, A., Fogari, E., Palumbo, I., Randazzo, S., et al. (2010) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2010.493557 · Cited by 37 · see citing works
Fernandes, J. F. R., Araújo, L. D. S., Kaiser, S., Sanjuliani, A. F., & Klein, M. R. S. T. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515004018 · Cited by 37 · see citing works
González‐Muniesa, P., López-Pascual, A., Andrés, J. D., Lasa, A., Portillo, M. P., Arós, F., Duran, J., Egea, C., & Martínez, J. A. (2015) · Journal of Physiology and Biochemistry · doi:10.1007/s13105-015-0410-3 · Cited by 33 · see citing works
Lewis, K. H., Gudzune, K. A., Fischer, H. J., Yamamoto, A., & Young, D. R. (2016) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2016.06.015 · Cited by 32 · see citing works
Koball, A. M., Mueller, P. S., Craner, J. R., Clark, M. M., Nanda, S., Kebede, E. B., & Grothe, K. B. (2016) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-016-0304-6 · Cited by 32 · see citing works
Schuster, R. J., Tasosa, J., & Terwoord, N. A. (2008) · The Journal of nutrition, health and aging · doi:10.1007/bf03028627 · Cited by 30 · see citing works
Shechter, A., Foster, G. D., Lang, W., Reboussin, D. M., St‐Onge, M., Zammit, G., Newman, A. B., Millman, R. P., Wadden, T. A., Jakicic, J. M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12559 · Cited by 30 · see citing works
Truant, A. P., Olon, L. P., & Cobb, S. (1972) · PubMed · Cited by 27 · see citing works
Blomfield, R. L., Collins, C. E., Hutchesson, M., Young, M. D., Jensen, M. E., Callister, R., & Morgan, P. J. (2013) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2013.09.004 · Cited by 26 · see citing works
Igelström, H., Åsenlöf, P., Emtner, M., & Lindberg, E. (2017) · Sleep And Breathing · doi:10.1007/s11325-017-1597-z · Cited by 26 · see citing works
Igelström, H., Margareta, E., Eva, L., & Åsenlöf, P. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0929-x · Cited by 24 · see citing works
Apovian, C. M., & Aronne, L. J. (2015) · Circulation · doi:10.1161/circulationaha.114.010772 · Cited by 23 · see citing works
Hood, M. M., Corsica, J. A., Cvengros, J. A., & Wyatt, J. K. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.12.006 · Cited by 21 · see citing works
Young, M. D., Collins, C. E., Callister, R., Plotnikoff, R. C., Doran, C. M., & Morgan, P. J. (2014) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.11.004 · Cited by 19 · see citing works
Moss, J., Tew, G. A., Copeland, R. J., Stout, M., Billings, C., Saxton, J., Winter, E., & Bianchi, S. M. (2014) · BioMed Research International · doi:10.1155/2014/102164 · Cited by 18 · see citing works
Ahn, S., Smith, M. L., & Ory, M. G. (2012) · Journal of Aging and Health · doi:10.1177/0898264312454573 · Cited by 15 · see citing works
Effects of a combined behavioral and pharmacological program on weight loss.
Dr, B., & Cs, N. (1979) · PubMed · Cited by 14 · see citing works
Nerfeldt, P., Nilsson, B., Uddén, J., Rössner, S., & Friberg, D. (2008) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2008.03.002 · Cited by 13 · see citing works
Interest in bariatric surgery among obese patients with obstructive sleep apnea
Dudley, K. A., Tavakkoli, A., Andrews, R. A. F., Seiger, A. N., Bakker, J. P., & Patel, S. R. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.01.006 · Cited by 9 · see citing works
Self-citationDOUBLE‐BLIND TRIAL OF ANORECTIC AGENTS
Sproule, B. (1969) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1969.tb92170.x · Cited by 8 · see citing works
Obese, fat, or just overweight?
Strømmen, M., Bakken, I. J., Andenæs, E., et al. (2015) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.14.0828 · Cited by 5 · see citing works
Newman, A. B. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.20.2408 · Cited by 5 · see citing works
Effects of diet, exercise and anorexigenic drugs on serum thyroid hormones.
Sonka, J., Limanova, Z., Zbírková, A., et al. (1980) · PubMed · Cited by 4 · see citing works
Habdank, K., Paul, T. L., Sen, M., et al. (2006) · Sleep Medicine · doi:10.1016/j.sleep.2006.07.176 · Cited by 3 · see citing works
Association between chronic stress and body composition in European adolescents
Vriendt, T. D., Clays, E., Molnár, D., et al. (2009) · Ghent University Academic Bibliography (Ghent University) · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 7
- [7]7. Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med 2013;159:471-483.
- [13]13. Review Manager (RevMan) [computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014.
- [19]19. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults-the evidence report. Obes Res 1998;6(Suppl 2):51S-209S. [Published erratum appears in Obes Res 1998;6:464.]
- [77]77. Cocco G, Pandolfi S, Rousson V. Sufficient weight reduction decreases cardiovascular complications in diabetic patients with the metabolic syndrome. Heartdrug 2005;5:68-74.
- [101]101. Wise PJ. Clinical experience with a new dosage form of phentermine hydrochloride. Obes Bariatr Med 1975;4:102-105.
- [119]119. Heindorff H, Hougaard K, Larsen PN. Laparoscopic adjustable gastric banding increases weight loss compared to dietary treatment: a randomized study [abstract]. Obes Surg 1997;7:300-301.
- [122]122. Canadian Agency for Drugs and Technologies in Health (CADTH). Bariatric surgical procedures for obese and morbidly obese patients: a review of comparative clinical and cost-effectiveness, and guidelines. Ottawa, ON, Canada: CADTH; 2014.
Cited by
Sorted by citations
Diagnosis and Management of Obstructive Sleep Apnea: A Review
Gottlieb, D. J., & Punjabi, N. M. (2020) · JAMA · doi:10.1001/jama.2020.3514 · Cited by 1,482 · see citing works
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
Malhotra, A., Grunstein, R. R., Fietze, I., Weaver, T. E., Redline, S., Azarbarzin, A., Sands, S. A., Schwab, R. J., Dunn, J. P., Chakladar, S., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2404881 · Cited by 871 · see citing works
Self-citationObstructive Sleep Apnea in Adults
Veasey, S. C., & Rosen, I. M. (2019) · New England Journal of Medicine · doi:10.1056/nejmcp1816152 · Cited by 615 · see citing works
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350 · see citing works
Self-citationCastellana, M., Conte, E., Cignarelli, A., Perrini, S., Giustina, A., Giovanella, L., Giorgino, F., & Trimboli, P. (2020) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-019-09514-y · Cited by 249 · see citing works
Neeland, I. J., Eliasson, B., Kasai, T., Marx, N., Zinman, B., Inzucchi, S. E., Wanner, C., Zwiener, I., Wojeck, B. S., Yaggi, H. K., et al. (2020) · Diabetes Care · doi:10.2337/dc20-1096 · Cited by 93 · see citing works
Georgoulis, M., Yiannakouris, N., Kechribari, I., Lamprou, K., Perraki, E., Vagiakis, E., & Kontogianni, M. D. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9834 · Cited by 56 · see citing works
Donovan, L. M., Shah, A., Chai-Coetzer, C. L., Barbé, F., Ayas, N. T., & Kapur, V. K. (2020) · Chest · doi:10.1016/j.chest.2019.10.002 · Cited by 36 · see citing works
Self-citationReceipt of weight management services among patients with OSA and obesity
Leonhard, A. G., McDowell, J., Hoerster, K. D., Hayes, S., Picazo, F., Castaneda, J. M., Josey, K., Griffith, M., Ma, J., Duan, K. I., et al. (2025) · CHEST Pulmonary · doi:10.1016/j.chpulm.2025.100156 · Cited by 1 · see citing works
- Authors
- Hudgel, D. W., Patel, S. R., Ahasic, A. M., Bartlett, S. J., Bessesen, D. H., Coaker, M. A., Fiander, P. M., Grunstein, R. R., Gurubhagavatula, I., Kapur, V. K., Lettieri, C. J., Naughton, M. T., Owens, R. L., Pepin, J.-L. D., Tuomilehto, H., & Wilson, K. C.
- Affiliations
- American Thoracic Society (US)
- McGill University (CA)
- University of Colorado Denver (US)
- University of California San Diego (US)
- Corresponding author
- Hudgel, David W.
- ORCID
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-09
- Volume
- 198
- Issue
- 6
- Pages
- e70-e87
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2889898238
- Cited by
- 266
- References
- 142
- Citations by year
- 2026: 41 · 2025: 40 · 2024: 48 · 2023: 24 · 2022: 41 · 2021: 23 · 2020: 30 · 2019: 18 · 2018: 1
- FWCI
- 12.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Thoracic Society
- University of Pennsylvania
- University of Washington
- University of Pittsburgh
- McGill University
- Monash University
- Uniformed Services University of the Health Sciences
- University of California, San Diego
- Perelman School of Medicine, University of Pennsylvania
- 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, obesity, overweight, weight management, weight loss, lifestyle intervention, hypocaloric diet, physical activity, behavioral weight management, bariatric surgery, cardiometabolic comorbidities, quality of life
- MeSH terms
- Adult, Diet, Reducing, Humans, Obesity, Societies, Medical, United States, Sleep Apnea, Obstructive, Overweight, Weight Reduction Programs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
