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Amount of weight loss or gain influences the severity of respiratory events in sleep apnea

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Abstract

Severity of obstructive sleep apnea (OSA) is estimated based on respiratory events per hour [i.e., apnea–hypopnea index (AHI)]. The aim of this study was to investigate effects of weight change on the severity of respiratory events. Respiratory event severity, including duration and morphology, was estimated by determining parameters quantifying obstruction and desaturation event lengths and areas, respectively. Respiratory events of 54 OSA patients treated with dietary intervention were evaluated at baseline and after 5-year follow-up in subgroups with different levels of weight change. AHI, oxygen desaturation index (ODI) and obstruction event severities decreased during weight loss. In lower level weight loss, the decrease was milder in obstruction severity than in AHI and ODI, indicating that the decrease in the number of events is more focused on less severe events. In weight gain groups, parameters incorporating obstruction event severity, AHI and ODI increased, although increase was greater in parameters incorporating obstruction event severity. The number and severity of respiratory events were modulated differently by the level of weight change. AHI misses this change in the severity of respiratory events. Therefore, parameters incorporating information on the respiratory event severities may bring additional information on the health effects obtained with dietary treatment of OSA.

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Acknowledgments

The study was financially supported by the Seinäjoki Central Hospital, the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital, Grant numbers VTR3040 and VTR3114 and Kuopio University Hospital (Competitive State Research Financing, Project 5041732 and Project 5041740). The authors have no financial or personal relationships with other people or organization that could have inappropriately influenced the study presented in this paper.

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Authors and Affiliations

  1. Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Hanneksenrinne 6, 60220, Seinäjoki, Finland

    A. Kulkas

  2. Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland

    T. Leppänen, P. Tiihonen, E. Mervaala & J. Töyräs

  3. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland

    A. Kulkas, T. Leppänen & J. Töyräs

  4. Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland

    J. Sahlman & J. Seppä

  5. Faculty of Health Sciences, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

    J. Sahlman, E. Mervaala & J. Seppä

  6. Department of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland

    J. Kokkarinen & J. Randell

  7. Oivauni Sleep Clinic, Kuopio, Finland

    H. Tuomilehto

  8. Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    H. Tuomilehto

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  1. A. Kulkas
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Correspondence to A. Kulkas.

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Kulkas, A., Leppänen, T., Sahlman, J. et al. Amount of weight loss or gain influences the severity of respiratory events in sleep apnea. Med Biol Eng Comput 53, 975–988 (2015). https://doi.org/10.1007/s11517-015-1290-y

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  • DOI: https://doi.org/10.1007/s11517-015-1290-y

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