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Early gain in body mass with continuous positive airway pressure therapy for obstructive sleep apnea

Early body mass gain with CPAP therapy

Anfängliche Gewichtszunahme bei kontinuierlicher Positivdruck-Therapie wegen obstruktiver Schlafapnoe

Anfängliche Gewichtszunahme bei CPAP-Therapie

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Abstract

Study objectives

Many clinicians believe that continuous positive airway pressure (CPAP) therapy of obstructive sleep apnea (OSA) is associated with a decrease in body mass, but to date, studies generally suggest long-term stability in body mass after 1 year. We have seen body mass increase after 4 weeks of treatment with CPAP in most patients with OSA. In this study, we test the hypothesis that therapy of OSA with CPAP produces a short-term gain in body mass, and look for physiological correlates to suggest an underlying mechanism.

Methods

Retrospective analysis of 218 consecutive patients treated for sleep apnea at a community-based sleep center.

Results

A total of 152 patients met the criteria for study conclusion. After 1 month of CPAP treatment, 119 subjects (78%) gained mass, including 81% of men and 73% of women. As a group, subjects on CPAP gained 1.4±2.5 kg (mean±SD). The Epworth Sleepiness Scale was reduced after 1 month of CPAP therapy. There was no correlation between gain in body mass and measured parameters. A subgroup of 71 patients remained on therapy. They demonstrated a gain in mass at 4 weeks, which did not persist at 6 months.

Conclusions

CPAP treatment of OSA is associated with gain in body mass at 1 month but not 6 months of therapy. The nature of this gain in mass remains unknown. We believe the gain is due to increased vascular volume, and might represent an early marker of physiological benefit of CPAP. This article includes a review of potential mechanisms for early increase in body mass with CPAP.

Zusammenfassung

Fragestellung

Viele klinisch tätige Ärzte gehen davon aus, dass eine kontinuierliche Positivdruck (CPAP)-Therapie bei obstruktiver Schlafapnoe (OSA) mit Gewichtsabnahme einhergeht, allerdings legen Studien bis heute eine Langzeitstabilität des Gewichts nach einem Jahr nahe. Wir haben bei den meisten Patienten mit OSA nach 4 Wochen CPAP-Therapie eine Gewichtszunahme beobachtet. In dieser Studie prüfen wir die Hypothese, dass die CPAP-Therapie einer OSA mit einer kurzfristigen Gewichtszunahme einhergeht, und versuchen, physiologische Korrelate für mögliche zugrunde liegende Pathomechanismus zu finden.

Methoden

Retrospektive Untersuchung von 218 konsekutiven Patienten, die gegen Schlafapnoe in einem kommunalen Schlafzentrum behandelt wurden.

Ergebnisse

Den Einschlusskriterien der Studie entsprachen 152 Patienten. Nach einer einmonatigen CPAP-Behandlung war bei 119 (78%; 81% der Männern und 73% der Frauen), eine Gewichtszunahme erfolgt (1,4±2,5 kg, Mittelwert ± Standardabweichung: 1,4±2,5 kg). Die Epworth-Schläfrigkeitsskala war nach einem Monat der CPAP-Therapie reduziert. Es gab keine Korrelation zwischen der Körpergewichtszunahme und den gemessenen Parametern. Eine Untergruppe von 71 Patienten führte die Therapie fort. Sie demonstrierten Gewichtszunahme nach 4 Wochen, die sich nicht über 6 Monate hielt.

Schlussfolgerungen

Die CPAP-Behandlung einer OSA ging mit einer Gewichtszunahme innerhalb des ersten Monats einher, die sich nicht über 6 Monate hielt. Die Ursache dafür bleibt unklar. Wir glauben, dass die Gewichtszunahme durch eine Vergrößerung des Gefäßvolumens verursacht wird und dies ein frühes Merkmal für eine physiologische Kompensation sein könnte. Die Diskussion beinhaltet eine Übersicht über die möglichen Mechanismen für die frühe Gewichtszunahme bei der Anwendung von CPAP.

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Acknowledgments

We thank the staff of the Regional Center for Sleep Medicine of Toledo, OH. This research was supported by the Metabolic Research and Teaching Fund at University of Toledo.

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Toledo College of Medicine, 3000 Arlington Ave., Mail Stop 1186, 43614, Toledo, OH, USA

    R.E. Bourey MD, FAASM & A. Balaa

  2. Center for Diabetes and Endocrine Research, University of Toledo College of Medicine, Toledo, OH, USA

    R.E. Bourey MD, FAASM

  3. Division of Endocrinology, University of Toledo College of Medicine, Toledo,, OH, USA

    R.E. Bourey MD, FAASM & J.R. Bourey

  4. College of Pharmacy, University of Toledo, Toledo, OH, USA

    N. Habbal

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  1. R.E. Bourey MD, FAASM
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  2. J.R. Bourey
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  3. N. Habbal
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  4. A. Balaa
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Correspondence to R.E. Bourey MD, FAASM.

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Research Site: University of Toledo College of Medicine, Toledo, OH.

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Bourey, R., Bourey, J., Habbal, N. et al. Early gain in body mass with continuous positive airway pressure therapy for obstructive sleep apnea. Somnologie 14, 207–212 (2010). https://doi.org/10.1007/s11818-010-0483-8

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  • DOI: https://doi.org/10.1007/s11818-010-0483-8

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