Abstract
Objective:
Obstructive sleep apnoea (OSA) occurs frequently in obese patients and may be reversible with weight loss. Obstructive sleep apnoea and obesity are both independent risk factors for hypertension and increased sympathetic activity. Sibutramine has been increasingly used in the management of obesity, but is relatively contraindicated in patients with hypertension. No studies have investigated the effect of sibutramine on OSA, blood pressure and heart rate. We aimed to assess the changes in OSA and cardiovascular parameters in obese men with OSA enrolled in a sibutramine-assisted weight loss programme (SIB-WL).
Design:
Open uncontrolled cohort study of obese male subjects with OSA in an SIB-WL.
Subjects:
Eighty-seven obese (body mass index =34.2±2.8 kg/m2) middle-aged (46.3±9.3 years) male subjects with symptomatic OSA (Epworth score 13.4±3.6; respiratory disturbance index (RDI) 46.0±23.1 events/h) completed the study.
Results:
At 6 months, there was significant weight loss (8.3±4.7 kg, P<0.0001), as well as a reduction in waist and neck circumference and sagittal height (all P<0.0001). These changes were accompanied by a reduction in OSA severity (RDI fell by 16.3±19.4 events/h and Epworth score by 4.5±4.6), both P<0.0001). There was no significant change to systolic (P=0.07) or diastolic blood pressure (P=0.87); however, there was a mild rise in resting heart rate (P<0.0001).
Conclusion:
Moderate (∼10%) weight loss with SIB-WL results in improvement in OSA severity without increase in blood pressure in closely monitored OSA subjects.
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Acknowledgements
We thank the Sally Beresford, Suyen Moncada, Anthony Williams, David Wang and Kerri Melehan for their technical support for the study. The study was partly funded by Abbott Laboratories, Sydney, Australia and the National Health and Medical Research Council Grant Number 301936. Professor Grunstein is a recipient of an NHMRC Practitioner Fellowship.
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Yee, B., Phillips, C., Banerjee, D. et al. The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea. Int J Obes 31, 161–168 (2007). https://doi.org/10.1038/sj.ijo.0803363
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DOI: https://doi.org/10.1038/sj.ijo.0803363
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