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Research Letters |

Weight Reduction and Increased Physical Activity to Prevent the Progression of Obstructive Sleep Apnea: A 4-Year Observational Postintervention Follow-up of a Randomized Clinical Trial

Henri Tuomilehto, MD, PhD; Juha Seppä, MD, PhD; Matti Uusitupa, MD, PhD; Jaakko Tuomilehto, MD, MA, PhD; Helena Gylling, MD, PhD; for the Kuopio Sleep Apnea Group
JAMA Intern Med. 2013;173(10):930-932. doi:10.1001/jamainternmed.2013.389.
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Obstructive sleep apnea (OSA) has become a major health burden in affluent populations. It is a chronic, progressive disease, and it is well documented that severe OSA is associated with increased cardiovascular morbidity and mortality.13 Obesity is the most important risk factor for OSA; in fact, most patients with OSA are obese.4 Weight reduction has been shown to improve OSA or even cure it.5,6 However, whether beneficial changes related to weight loss are maintained after stopping the active lifestyle intervention, and, thus, the progression of OSA prevented, is not known. The aim of the study was to assess the long-term efficacy of a lifestyle intervention based on weight reduction, healthy diet, and physical activity during a 4-year postintervention follow-up in people with OSA who originally participated in a 1-year randomized, clinical lifestyle intervention trial.5

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Figure. Progression of obstructive sleep apnea (OSA) by treatment group during the postintervention follow-up period. Kaplan-Meier estimate of probability of progression of OSA. The difference between the survival curves was tested with the log-rank test. The Cox proportional hazard model was used to estimate the hazard ratio for the progression of OSA. There were 14 events in the control group and 6 in the intervention group. The incidence rate for the control group was 0.7 (95% CI, 0.4-1.3), and for the intervention group, 0.3 (95% CI, 0.1-0.7). Log-rank test,  = .04. Hazard ratio, 0.39 (95% CI, 0.2-1.0) ( = .049).

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