Weight reduction as one effect of a multidisciplinary intervention for people with obesity and CPAP-treated sleep apnoea

Introduction

Obesity is a chronic disease that causes medical, psychological and social consequences. This life-threatening disorder is defined as Body Mass Index (BMI) ≥ 30 and is associated with obstructive sleep apnoea syndrome (OSAS).
      The diagnosis of OSAS is confirmed by the nightly average number of apnoea per hour. One of the most common treatments of OSAS is the application of constant positive airway pressure (CPAP).

Objectives

We hypothesized that a multidisciplinary intervention performed by an occupational therapist, a physiotherapist and a dietician would lead to:
• Weight reduction
• Changes in life style concerning diet and physical activity
• Increase the ability to perform daily activities
• Provide positive effects in health related quality of life (HRQL).

The aim was to increase the ability for persons with obesity and CPAP-treated OSAS to lose weight and further to transfer knowledge of the importance of changing behaviour concerning diet habits and physical activity and thereby be able to achieve lasting changes.

Methods

Adult persons were randomized towards an intervention or a control group. There was no significant difference between the groups at base-line (BMI 37.1 respectively 36.0).

The multidisciplinary intervention represent a jointly treatment program. The model included group tuition with a scheduled program, home work and weight controls at 10 occasions.
The team met each participant individually for specific professional data sampling. These data constituted the base for further planning of individual and group interventions. The control group got a booklet about how to lose weight. Follow-up was performed after 12 respectively 24 months.

Results

Primary outcome: weight, waist circumference and BMI were significant decreased (p<0.05) for the intervention group at 12 months follow-up and the waist circumference was still significant at 24 months. The only significant change in the control group was waist circumference at 12 months. There were no statistically significant differences between the groups at 12 months follow-up respectively 24 months.
The secondary outcome for the intervention group showed increased physical activity, decreased pain, changed diet habits, increased ability to perform daily activities and increased HRQL (bodily pain, physical function, role emotional and mental health). There was no statistically significant difference related to HRQL between the groups at 12 months follow-up respectively 24 months.

 

Conclusion

A multidisciplinary intervention might help patients with obesity and CPAP-treated OSAS to lose weight.
Screening methods concerning needs of support and motivation analyses maybe necessary for long lasting changes.

 

References:
I. Melin and S. Rössner, Practical clinical behavioural treatment of obesity. Patient Education and Counselling, 2003. 49: p. 75-83.
C. Holmdahl, et al. CPAP treatment in obstructive sleep apnoea: A randomised, controlled trial of follow-up with a focus on patient satisfaction. Sleep Medicine, 2009. 10: p. 869-874.