Are Lifestyle Changes Combined With CPAP Effective Treatments for Obstructive Sleep Apnea?
Are you currently using a CPAP machine to treat obstructive sleep apnea (OSA)? Or do you snore loudly, wake up choking or regularly wake up feeling excessively sleepy or sleepy throughout the day? If you do, it may be worth paying a visit to a doctor as these are symptoms of sleep apnea that can have dangerous long-term health effects if left untreated.
Obstructive sleep apnea (OSA) is when the muscles in the back of your throat relax too much during sleep. This causes the airways to narrow or close for a bit. Because of these breaks, your body can’t take in the oxygen it needs, so your brain signals you to wake up to start breathing again.
OSA not only messes with your sleep but also puts you at risk of having health problems. This happens because the drop in oxygen levels during sleep makes your heart beat faster and your blood pressure go up. It also becomes more difficult for your cells and tissues to take in glucose from the blood, which over a prolonged period can lead to type 2 diabetes.
Most doctors recommend continuous positive airway pressure (CPAP) for treating OSA. This device blows air into your nose or mouth through a tube while you sleep, creating pressure and keeping your airway open. It’s very effective, but because of the nature of the CPAP device that’s worn while sleeping, some people find it challenging to use regularly. However, researchers from the University of Granada in Spain found that there might be ways to improve this treatment.
OSA affects around 39 million people in the USA, and it’s more common in men – they’re four times more likely than women to have it. Older adults and people who are overweight or obese are also at a higher risk.
Losing weight seems to significantly improve OSA and related conditions. But only a few clinical studies have looked at this so far. Moreover, many studies focus on restrictive diets or physical exercise without addressing lifestyle changes such as avoiding alcohol and quitting smoking.
This study filled this gap by showing how a mix of weight loss and lifestyle changes can improve OSA in adults using CPAP treatment.
The Role of Lifestyle Interventions in OSA Treatment
The scientists behind this study recruited 89 overweight or obese men (mean age 54 years) with OSA who were using CPAP. They divided the participants into two groups. One group was subjected to a weight loss and lifestyle intervention combined with CPAP treatment, while the other group continued using CPAP only.
The lifestyle intervention lasted eight weeks and involved changing eating habits, engaging in moderate aerobic exercise, quitting smoking, avoiding alcohol, and developing healthy sleep routines—all of which have been proven to be beneficial across a range of long-term health benefits. The goal was to determine the effects of the combined strategy on OSA severity.
To start, the researchers conducted a sleep study to establish a baseline for each participant’s sleep apnea severity and how it changed at the end of the intervention and six months later. OSA severity was measured using AHI, the Apnea-Hypopnea Index. Between zero and four events per hour is considered normal. If there are five to 14 events, it’s classified as mild OSA. Anything above 30 events in an hour is considered severe OSA. They also examined changes in sleep patterns and blood oxygen levels.
Next, the researchers had the participants fill out a series of questionnaires. One questionnaire, the Pittsburgh Sleep Quality Index, measured how well they slept. Another, the Epworth Sleepiness Scale, asked about how sleepy they felt. Last, the Sleep Apnea Quality of Life Index measured how much sleep apnea impacted their quality of life.
The researchers also looked at things like body composition, weight, blood sugar levels, blood pressure, lifestyle choices, and eating habits to understand how the intervention affected participants’ health.
People who underwent the lifestyle intervention saw their OSA improve. Their AHI dropped by 51%, going from 41.6 to 20.4 events per hour. These improvements lasted even six months after the intervention ended. However, those who only used CPAP didn’t see any changes in their AHI.
For most people, OSA severity improved. Twelve percent went from severe to mild OSA, and 15% experienced complete remission. What’s more, 45% of participants no longer needed CPAP therapy afterward, and at the 6-month mark this number had grown to 62%.
But these weren’t the only benefits. After 8 weeks of the lifestyle intervention, participants experienced:
- better sleep quality,
- feeling less sleepy,
- having an easier time staying asleep,
- losing weight and having a lower BMI,
- seeing improvements in blood pressure, blood sugar levels, and liver function,
- reducing alcohol and tobacco consumption,
- improving physical activity and eating habits, and
- noticing an improvement in their overall quality of life.
These positive changes were maintained in the long term and show that people with OSA should consider adopting healthier lifestyle habits alongside traditional CPAP therapy.
Living Better With OSA
Living with OSA can be challenging as it messes with your sleep and your ability to function, and if you share your bed with a partner it can be disruptive to their sleep as well. Having healthy lifestyle habits can ease some of the symptoms. Here are some things you can try:
- keep a healthy weight,
- drink less alcohol,
- quit smoking,
- exercise regularly, and
- keep healthy sleep habits.
OSA is serious, but the good thing it’s treatable. If you snore loudly, wake up choking, or feel sleepy during the day, talk to your doctor.
