Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta‐analysis

Obesity Reviews, Journal Year: 2019, Volume and Issue: 20(5), P. 750 - 762

Published: Jan. 4, 2019

Summary Lifestyle interventions addressing diet, exercise‐training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta‐analysis was aimed at establishing (a) lifestyle apnoea‐hypopnoea index (AHI), oxygen desaturation (ODI), excessive daytime sleepiness (EDS), secondary OSA measures among adults, (b) which intervention characteristics may drive greatest improvements. A search studies conducted using CINAHL, ProQuest, Psicodoc, Scopus, Web Science, from inception to April 2018. Standardized mean differences were calculated inverse variance method random‐effects models. The meta‐analyses 13 randomized controlled trials 22 uncontrolled before‐and‐after (1420 participants) revealed significant reductions AHI ( d = −0.61 −0.46, respectively), ODI −0.46) EDS −0.41 −0.49). Secondary outcomes also improved after interventions. However, differed depending components, severity, gender. Thus, until future research supports differential OSA, those weight loss through diet exercise‐training be most effective treatments for male patients with moderate‐severe OSA.

Language: Английский

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Sex differences in the circadian misalignment effects on energy regulation

Proceedings of the National Academy of Sciences, Journal Year: 2019, Volume and Issue: 116(47), P. 23806 - 23812

Published: Nov. 4, 2019

Shift work causes circadian misalignment and is a risk factor for obesity. While some characteristics of the human system energy metabolism differ between males females, little known about whether sex modulates effects on homeostasis. Here we show-using randomized cross-over design with two 8-d laboratory protocols in 14 young healthy adults (6 females)-that has sex-specific influences homeostasis independent behavioral/environmental factors. First, affected 24-h average levels satiety hormone leptin sex-dependently (P < 0.0001), ∼7% decrease females 0.05) an ∼11% increase 0.0001). Consistently, also increased hunger ghrelin by ∼8% during wake periods without significant effect males. Females reported reduced fullness, consistent their appetite changes. However, rise cravings energy-dense savory foods not homeostatic hormonal changes, suggesting involvement hedonic pathways Moreover, there were sex-dependent respiratory quotient 0.01), significantly values 0.01) when misaligned, again no males, expenditure. Changes sleep, thermoregulation, behavioral activity, lipids, catecholamine assessed. These findings demonstrate that metabolism, indicating possible mechanisms countermeasures obesity male female shift workers.

Language: Английский

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A comprehensive diagnostic approach to detect underlying causes of obesity in adults

Obesity Reviews, Journal Year: 2019, Volume and Issue: 20(6), P. 795 - 804

Published: March 1, 2019

Summary Obesity is a worldwide growing problem. When confronted with obesity, many health care providers focus on direct treatment of the consequences adiposity. We plead for adequate diagnostics first, followed by an individualized treatment. provide experience‐based and evidence‐based practical recommendations (illustrated clinical examples), to detect potential underlying diseases contributing factors. Adult patients consulting doctor weight gain or obesity should first be clinically assessed diseases, such as monogenetic syndromic hypothyroidism, (cyclic) Cushing syndrome, polycystic ovarian syndrome (PCOS), hypogonadism, growth hormone deficiency, hypothalamic obesity. The most important alarm symptoms genetic are early onset dysmorphic features/congenital malformations without intellectual deficit, behavioral problems, hyperphagia, and/or striking family history. Importantly, also common factors investigated, including medication (mainly psychiatric drugs, (local) corticosteroids, insulin, specific β‐adrenergic receptor blockers), sleeping habits quality, crash diets yoyo‐effect, smoking cessation, alcoholism. Other associated conditions include mental chronic stress binge‐eating disorder depression.Identifying optimizing factors, other may not only result in more effective personalized but could reduce social stigma

Language: Английский

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Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies

Nature and Science of Sleep, Journal Year: 2018, Volume and Issue: Volume 10, P. 45 - 64

Published: Jan. 31, 2018

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances disorders including obstructive apnea excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without syndrome. Evidence from few available population-based supportive. Women tend be overweight/obese, but this only partly accounts for their problems as associations are generally upheld after adjustment body mass index; also in normal weight. There several, possibly bidirectional, pathways through which associated disturbances. The pathophysiology involves hyperandrogenemia, form insulin resistance unique affected women, possible changes cortisol melatonin secretion, arguably reflecting altered hypothalamic-pituitary-adrenal function. Psychological behavioral likely play role, anxiety depression, smoking, alcohol use lack physical activity common PCOS, response distressing symptoms they experience. specific impact on not yet clear; however, both deterioration cardiometabolic longer term increased risk type 2 diabetes. Both immediate quality life longer-term benefit diagnosis management part interdisciplinary care.

Language: Английский

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Evidence‐based weight loss interventions: Individualized treatment options to maximize patient outcomes

Diabetes Obesity and Metabolism, Journal Year: 2020, Volume and Issue: 23(S1), P. 50 - 62

Published: Sept. 24, 2020

Against the backdrop of obesity as a major public health problem, we examined three questions: How much weight loss is needed to benefit patients with obesity? well do current therapies in producing loss? What strategies can be used improve patient outcomes using evidence-based studies. This paper reviews literature on lifestyle, diet, medications and surgical treatments for searches treatments. Current treatments, including diet exercise, produce 5% 7% average. Despite continued attempts identify superior dietary approaches, most careful comparisons find that low carbohydrate diets are not significantly better than fat loss. The four currently approved by US Food Drug Administration long-term management effective surgery, adding about average lifestyle approaches Two new under investigation, semaglutide tirzepatide, this. For all loss, there enormous variability amount lost. Examination this has yielded evidence supporting baseline process predictors, but effect sizes associated these predictors small no prospective studies showing personalized approach based genotype or phenotype will yield uniform success. Because chronic disease it requires 'continuous treatment model' across lifespan.

Language: Английский

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