Increased BMI in Patients with OSA after CPAP Treatment

CPAP treatment for individuals with OSA can result in many different outcomes, depending on the severity of the OSA and the physical health of the individual.  Most people with OSA are overweight, with a BMI of over 25.  More than 50% of people with OSA are obese, (BMI over 30).  Because obesity can lead to OSA, and vice-versa, it can be difficult to establish what the initial problem was.

In this study, BMI increased following CPAP therapy, particularly among those with CPAP use of 5 hours or less per night, and those without cardiovascular disease (incidence 50% higher in women than men).  The longer the CPAP is used every night, and the longer duration in years, the higher the amount of potential cumulative weight gain.  It is possible that greater CPAP adherence leads to a greater decrease in leptin.  Leptin is a hormone in the small intestine that helps to regulate hunger and energy levels while diminishing fat storage. 

There are also extra energy demands if an individual has OSA, resulting in positive energy balance, leading to slow weight gain and increased BMI over time.  Changes in dietary habits and physical activity can play a large role in treatment for both OSA and obesity.  Physicians should promote an active weight loss plan and not rely solely on the CPAP for weight loss and BMI changes.  

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