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Sunday, October 4, 2009

Weight Loss and Apnea


More Benefits Seen With Weight Loss


For folks carrying around a few too many extra pounds, the benefits of losing weight can hardly be overestimated from a medical standpoint, even for those who are only modestly overweight. Cardiovascular disease, diabetes and arthritis all improve when extra poundage is shed, and now sleep apnea-that condition where people stop breathing during sleep-has joined the list.
In this issue of Archives of Internal Medicine, A Randomized Study on the Effect of Weight Loss on Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes, established that even modest weight loss was associated with significant improvement in sleep apnea. As might be expected, the more weight study participants lost, the greater the benefit.

While physicians who manage patients with sleep apnea have reported for years that weight loss helps, in so-called anecdotal reports, this is the largest, longest prospective study to specifically design an intervention, assess it, and chronicle its impact on episodes of breathing cessation during sleep. Such evidence is important to accumulate in order to convincingly prove the benefits of a specific intervention or therapy.

A previous study Rick and I reported on showed that sleep apnea is associated with an increased risk of death from any cause, not just cardiovascular problems. This effect was most pronounced in men younger than 70. Clearly this is a risk group where weight loss should be encouraged. Rick also points out that lifestyle interventions such as weight loss and increased exercise have no deleterious side effects and allow people to become fully engaged in their own health. In sum, a win-win all around.


Other topics this week included Shared Decision Making for Prostate Cancer Screening, also in Archives, and Cardiac-Resynchronization Therapy for the Prevention of Heart-Failure Events and Variation in Hospital Mortality Associated with Inpatient Surgery in the New England Journal of Medicine. Until next week, y'all live well.




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