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A nurse-managed weight reduction programme for obstructive sleep apnoea syndrome

J Lojander¹, P Mustajoki, S Rönkä

¹Department of Medicine, Helsinki University Central Hospital, Finland. jukka.lojander@fimnet.fi

Journal of Internal Medicine

|September 25, 1998

Summary

A weight and lifestyle program for obstructive sleep apnoea syndrome (OSAS) is safe, effective, and cost-efficient for pulmonary departments. This outpatient intervention led to significant weight loss and improved oxygen desaturation in patients.

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Area of Science:

Pulmonary Medicine
Sleep Medicine
Clinical Intervention Studies

Background:

Obstructive Sleep Apnoea Syndrome (OSAS) is a condition often associated with obesity.
Pulmonary departments are exploring cost-effective treatment options for OSAS.

Purpose of the Study:

To investigate the feasibility and effectiveness of a weight and lifestyle program as a primary treatment for OSAS.
To determine if pulmonary departments can implement such a program cost-effectively.

Main Methods:

A 1-year outpatient weight reduction program was implemented in a pulmonary department.
Participants (n=24) with moderate obesity and newly diagnosed OSAS followed a very low-calorie diet (VLCD) for 6 weeks, followed by a low-calorie diet.
Behavioral management through 12 group meetings and measurements of daytime somnolence, BMI, and oxygen desaturation index (ODI4).

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Main Results:

The program was easily administered with no serious side effects.
Patients achieved a mean weight loss of 33% of their overweight, with significant improvement in ODI4 (P < 0.005).
The cost per patient was approximately half the cost of nasal continuous positive airway pressure (nCPAP) treatment.

Conclusions:

A nurse-managed outpatient program using VLCD and behavioral management is a safe and effective primary treatment for OSAS in moderately overweight individuals.
Weight loss should be encouraged for OSAS patients with moderate overweight.
The necessary amount of weight loss for OSAS improvement varies individually.