In:
Journal of Sleep Research, Wiley, Vol. 26, No. 6 ( 2017-12), p. 747-755
Abstract:
The aim of this study was to determine if an intensive lifestyle intervention ( ILI ) reduces the severity of obstructive sleep apnea ( OSA ) in rapid‐eye movement ( REM ) sleep, and to determine if longitudinal changes in glycaemic control are related to changes in OSA severity during REM sleep over a 4‐year follow‐up. This was a randomized controlled trial including 264 overweight/obese adults with type 2 diabetes (T2D) and OSA . Participants were randomized to an ILI targeted to weight loss or a diabetes support and education ( DSE ) control group. Measures included anthropometry, apnea–hypopnea index ( AHI ) during REM sleep ( REM ‐ AHI ) and non‐ REM sleep ( NREM ‐ AHI ) and glycated haemoglobin (HbA1c) at baseline and year 1, year 2 and year 4 follow‐ups. Mean baseline values of REM ‐ AHI were significantly higher than NREM ‐ AHI in both groups. Both REM ‐ AHI and NREM ‐ AHI were reduced significantly more in ILI versus DSE , but these differences were attenuated slightly after adjustment for weight changes. Repeated‐measure mixed‐model analyses including data to year 4 demonstrated that changes in HbA1c were related significantly to changes in weight, but not to changes in REM ‐ AHI and NREM ‐ AHI . Compared to control, the ILI reduced REM ‐ AHI and NREM ‐ AHI during the 4‐year follow‐up. Weight, as opposed to REM ‐ AHI and NREM ‐ AHI , was related to changes in HbA1c. The findings imply that weight loss from a lifestyle intervention is more important than reductions in AHI for improving glycaemic control in T2D patients with OSA .
Type of Medium:
Online Resource
ISSN:
0962-1105
,
1365-2869
DOI:
10.1111/jsr.2017.26.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2007459-1
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