Sleep and Breathing

, Volume 17, Issue 3, pp 925–935 | Cite as

The impact of diet and lifestyle management strategies for obstructive sleep apnoea in adults: a systematic review and meta-analysis of randomised controlled trials

  • Maria-Anna Thomasouli
  • Emer M. Brady
  • Melanie J. Davies
  • Andrew. P. Hall
  • Kamlesh Khunti
  • Danielle H. Morris
  • Laura J. Gray



To systematically evaluate the impact of diet, exercise and lifestyle modification programmes on indices of obesity, Obstructive Sleep Apnoea (OSA) parameters and quality of life (QoL) in adults with OSA.


Electronic databases were searched to identify randomised controlled trials published in English with an intervention based on dietary weight loss, exercise and/or lifestyle programme in adults with OSA. Meta-analyses were conducted using random-effects models.


Twelve studies met the inclusion criteria with nine comparing similar interventions. Diet and diet plus continuous positive airway pressure (CPAP) therapy were compared in three studies (n = 261), and intensive lifestyle programmes and routine care were compared in six studies (n = 483). Diet with CPAP therapy reduced weight by −2.64 kg (95 % Confidence Interval (CI) −3.98, −1.30, I 2 = 0 %) compared with diet alone. No differences were observed for QoL or Epworth Sleepiness Scale. A significant reduction in weight was seen in participants receiving an intensive lifestyle intervention of −5.65 kg (95 % CI −10.91, −0.40, I 2 = 95.7 %) compared with controls. Reductions were also observed for waist circumference (−5.80 cm, 95 % CI −8.64, −2.96, I2 = 77.7 %), body mass index (BMI) (−2.33 kg/m2, 95 % CI −3.41, −1.24, I2 = 78.8 %) and the Apnoea Hypopnoea Index (AHI) (−4.55 events/h, 95 % CI −7.12, −1.98, I 2 = 54.4 %) but with high levels of heterogeneity.


Intensive lifestyle management can significantly reduce obesity indices and improve AHI. Future research is required to investigate this effect due to a limited number of studies identified.


Obstructive sleep apnoea Diet Lifestyle Randomised controlled trial Meta-analysis 


Financial Support

Funding was provided by the Leicester Diabetes Centre and the Hanning Sleep Laboratory.


The corresponding author and co-authors listed on this manuscript have no financial conflict of interest, and this research does not include off-label or investigational use of drugs or devices.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Maria-Anna Thomasouli
    • 1
    • 2
    • 6
  • Emer M. Brady
    • 3
  • Melanie J. Davies
    • 3
    • 4
  • Andrew. P. Hall
    • 2
  • Kamlesh Khunti
    • 1
    • 3
  • Danielle H. Morris
    • 5
  • Laura J. Gray
    • 1
  1. 1.Department of Health SciencesUniversity of LeicesterLeicesterUK
  2. 2.Sleep Disorders ServiceHanning Sleep Laboratory, University Hospitals of Leicester NHS TrustLeicesterUK
  3. 3.Leicester Diabetes CentreDiabetes Research Unit, University of LeicesterLeicesterUK
  4. 4.Department of Cardiovascular SciencesDiabetes Research Unit, University of LeicesterLeicesterUK
  5. 5.Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
  6. 6.Leicester Diabetes CentreUniversity of LeicesterLeicesterUK

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