Psychological interventions for weight management of patients with obstructive sleep apnea syndrome: A systematic...

Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder commonly associated with obesity, and weight management is considered a key therapeutic strategy. However, conventional weight-loss methods often fail due to poor long-term adherence. While psychological interventions may help address behavioral barriers, their effectiveness in managing weight in OSAS patients remains uncertain. This systematic review aimed to evaluate the effectiveness of psychological interventions for weight loss in individuals with OSAS.

A systematic search (up to April 2025) was conducted across PubMed, Embase, the Cochrane Library, Web of Science, and Scopus to identify randomized controlled trials (RCTs) evaluating psychological interventions in OSAS patients. The primary outcomes included changes in weight, BMI, and body circumference, while secondary outcomes focused on sleep quality, as measured by the Epworth Sleepiness Scale (ESS). (Registration ID: PROSPERO CRD420251024106).

Thirteen RCTs (N ≈ 1300) published between 1998 and 2022 were included. Overall, psychological interventions showed more consistent benefits for weight-related outcomes than for sleep-related outcomes. Reductions in body weight, BMI, waist circumference, and neck circumference were more frequently observed in intervention groups, whereas findings for hip circumference were limited. Most studies reporting ESS showed greater improvement in daytime sleepiness with psychological interventions than with control conditions. Studies reporting AHI also generally favored intervention, although the magnitude of benefit varied across trials. Most included studies were judged to have low risk of bias or some concerns.

Psychological interventions may be a useful adjunct to lifestyle-based management in adults with OSAS, with stronger evidence for weight-related than sleep-related benefits. Further high-quality trials are needed to determine long-term effectiveness.