Continuous positive airway pressure effects on energy expenditure, intake, hormonal regulation, and body composition: a randomized trial
Abstract
Study objectives: Weight gain after continuous positive airway pressure (CPAP) initiation in obstructive sleep apnea (OSA) is common, but its mechanism and relevance remain unclear. This open-label randomized trial evaluated CPAP effects on energy expenditure, intake, body composition, physical activity, and appetite-regulatory hormones.
Methods: Patients with OSA were randomized (1:1) to 12-week CPAP or inactive control. The primary outcome was resting energy expenditure (REE). Secondary outcomes included dietary intake, eating behavior, fat mass (FM), fat-free mass (FFM), and activity count. Tertiary outcomes included appetite-regulatory hormones. CPAP effects were assessed as baseline-adjusted between-group differences using intention-to-treat (ITT) analysis; Per-protocol analysis (completers) served as sensitivity analysis.
Results: Of 52 randomized participants, 45 completed the study. In ITT analysis, CPAP had no effect on REE (8.6 kcal/day [95% CI = -51.5 to 68.7]; p = .774) or caloric intake (144.4 kcal/day [95% CI = -123.1 to 411.9]; p = .283). Although insignificant in morning, CPAP significantly increased evening body weight (p = .017) and body mass index in morning and evening (p = .040 and .030). CPAP also increased FFM, raised acylated ghrelin and insulin-like growth factor 1, and reduced cortisol and cognitive restraint. No changes were observed in macronutrient intake, FM, activity, insulin resistance, leptin, or neuropeptide Y. Per-protocol findings were…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 52 participants or records.
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