Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Sleep Breath. 2013 Mar;17(1):227-34. doi: 10.1007/s11325-012-0677-3. Epub 2012 Feb 29.
Clinical and epidemiologic investigations suggest a strong association between obesity and obstructive sleep apnea (OSA). The purpose of this study is to evaluate the currently available literature reporting on the effectiveness of dietary weight loss in treating OSA among obese patients.
Relevant studies were identified by computerized searches of PubMed, EMBASE, CINAHL, Web of Science, and The Cochrane Central Register of Controlled Trials through September 2011 as well as the reference lists of all obtained articles. Information on study design, patient characteristics, pre- and post-dietary weight loss measures of OSA and body mass index (BMI), and study quality was obtained. Data were extracted by two independent analysts. Weighted averages using a random-effects model are reported with 95 % confidence intervals.
Nine articles representing 577 patients were selected. Dietary weight loss program resulted in a pooled mean BMI reduction of 4.8 kg/m(2) (95 % confidence interval [CI] 3.8-5.9). The random-effects pooled apnea hypopnea (AHI) indices at pre- and post-dietary intervention were 52.5 (range 10.0-91.0) and 28.3 events/h (range 5.4-64.5), respectively (p < 0.001). Compared to control, the weighted mean difference of AHI was decreased by -14.3 events/h (95 % CI -23.5 to -5.1; p = 0.002) in favor of the dietary weight loss programs.
Dietary weight loss programs are effective in reducing the severity of OSA but not adequate in relieving all respiratory events. Weight reduction programs should be considered as adjunct rather than curative therapy.
临床和流行病学研究表明肥胖与阻塞性睡眠呼吸暂停（OSA）之间存在很强的关联。本研究旨在评估目前有关饮食减肥对肥胖患者 OSA 治疗效果的文献。
通过计算机检索 PubMed、EMBASE、CINAHL、Web of Science 和 The Cochrane Central Register of Controlled Trials，检索时间截至 2011 年 9 月，并查阅所有获得文章的参考文献列表，以确定相关研究。获取研究设计、患者特征、饮食减肥前后 OSA 和体重指数（BMI）的测量值以及研究质量等信息。由两名独立分析人员提取数据。采用随机效应模型计算加权平均值，并报告 95%置信区间。
选择了 9 篇文章，共 577 例患者。饮食减肥方案导致 BMI 平均降低 4.8kg/m2（95%置信区间 3.8-5.9）。随机效应汇总的饮食干预前后呼吸暂停低通气指数（AHI）分别为 52.5（范围 10.0-91.0）和 28.3 次/小时（范围 5.4-64.5）（p<0.001）。与对照组相比，饮食减肥方案的 AHI 加权平均差异减少了-14.3 次/小时（95%置信区间-23.5 至-5.1；p=0.002），有利于饮食减肥方案。
饮食减肥方案可有效降低 OSA 的严重程度，但不能完全缓解所有呼吸事件。减重方案应被视为辅助而非治愈性治疗。
