Effect of very-low-calorie diets with weight loss on obstructive sleep apnea

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Abstract
To determine the effect of very-low-calorie diets (VLCDs) with weight loss on obstructive sleep apnea (OSA), we studied eight obese subjects with OSA, five males and three females. Subjects consumed a VLCD of 1760 kJ (420 kcal) (67% protein, 4% fat, 29% carbohydrate) or 3350 kJ (800 cal) (20% protein, 30% fat, 50% carbohydrate) with 100% of the recommended daily allowance of vitamins and minerals. Mean (±SD) values of weight and respiration before and after weight loss were, for weight, 153 ± 37 and 132 ± 29 kg (P < 0.05); for BMI (kg/m2), 54 ± 13 and 46 ± 10 (P < 0.05); for desaturations/h sleep, 106 ± 50 and 52 ± 45 (P < 0.05); for apneas + hypopneas/h sleep, 90 ± 32 and 62 ± 49; for PCO2, 48 ± 10 and 42 ± 4 torr (P < 0.05). Desaturation episodes/h and apnea + hypopneas/h improved in six patients. The most obese subject (female, BMI 81) who lost the most weight (47 kg) did not improve, nor did the subject who lost the least weight, 7 kg. The number of movements + arousals from sleep decreased in all patients (P < 0.05). We conclude that VLCD with weight loss can produce improvement in OSA; subjects who lose a small amount of weight or subjects who are extraordinarily obese before and after weight loss may not improve.