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High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients
Open accessAbstract
Study objectives Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users.Methods Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%.Results The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m(2), apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m(2)) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m(2)) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m(2)) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort.Conclusions In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life.
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Adherence rates to PAP are not lower among patients with obesity; some studies show superior adherence in this population.
“Interestingly, adherence rates are not lower among those with obesity, with some studies even demonstrating superior adherence in this population.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [793]
The Adherence to CPAP Treatment section (page not provided) reports that patients using CPAP for more than eight hours daily were more obese than the rest of the cohort, and that higher baseline BMI predicted increasing adherence. This supports an association between greater obesity and better adherence in this cohort, but does not establish the broader claim that adherence rates are not lower among patients with obesity than among patients without obesity. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCPAP adherence has not been associated with weight loss and may even lead to weight gain.
“CPAP adherence has not been associated with weight loss and may even lead to weight gain.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [793]
Untreated obstructive sleep apnea is associated with weight gain.
“Although untreated OSA is associated with weight gain”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [793]
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Metadata
- Authors
- Myllylä, M., Kurki, S., Anttalainen, U., Saaresranta, T., & Laitinen, T.
- Affiliations
- University of Turku (FI)
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2016-04-15
- Volume
- 12
- Issue
- 4
- Pages
- 519-528
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC4795278
- OpenAlex
- W2341044028
- Semantic Scholar
- 4aadbd1fe4d6505b532e09fa3f34e0567a1d539f
- Cited by
- 22
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 4 · 2016: 2
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hengityssairauksien Tutkimussäätiö
- Turun Yliopistollinen Keskussairaala
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- obstructive sleep apnea, CPAP adherence, weight gain, obesity, BMI trends, predictors of weight change, multimorbidity
- MeSH terms
- Female, Finland, Humans, Male, Middle Aged, Obesity, Patient Compliance, Severity of Illness Index, Weight Gain, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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