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What did I do?
The overall aim of this PhD was to design, implement and study the effects of an interdisciplinary weight loss and lifestyle intervention combined with usual care (ie, continuous positive airway pressure (CPAP)), as compared with usual care alone, on obstructive sleep apnea (OSA) severity, other sleep-related outcomes, body weight and composition and cardiometabolic risk in adults with CPAP-treated moderate-to-severe OSA and overweight/obesity.1 In addition, the efficacy of this behavioural approach at improving daily functioning and psychiatric symptoms, physical fitness and dietary behaviour in this population was also studied.1
Why did I do it?
OSA, characterised by recurrent sleep-state dependent upper-airway collapse with obesity as the leading attributable cause, is a major public health problem owing not only to its high and increasing prevalence—936 million adults aged 30–69 years globally—but also to its wide spectrum of clinical and socioeconomic consequences.2 3 Although CPAP is the first-line treatment for this condition, CPAP is a chronic day-to-day treatment, adherence rates are suboptimal—with overall non-adherence rates of 30%–40%—,4 and long-term benefits beyond reduction of upper-airway occlusions remain uncertain as it does not address the core high‐risk OSA factors, that is, obesity and adverse lifestyles.5 Conversely, alternative or combined behavioural interventions including weight loss through dietary approaches and exercise, sleep hygiene, and avoidance of alcohol and tobacco consumption appears to substantially improve OSA and coexisting conditions in adults with moderate-to-severe OSA.5 6 However, weight loss and behavioural approaches, although suggested, are still not a standard recommendation in existing clinical practice guidelines owing to the modest quality of evidence and methodological weaknesses found in this field of research.5 6
How did I do it?
First, a systematic review and meta-analysis on …
Contributors AC-B contributed to conception, design and supervision of the study, participated in data collection and acquisition, performed the statistical analyses, interpreted the data and wrote the report. AC-B is the guarantor and accepts full responsibility for the work.
Funding This PhD was supported by the Spanish Ministry of Education and Vocational Training, through a grant provided to AC-B. (FPU16/01093); the University of Granada-LoMonaco S.L. Sleep Research Cathedra; the University of Granada Plan Propio de Investigación 2016 –Excellence actions: Unit of Excellence on Exercise and Health (UCEES); and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (European Regional Development Funds, SOMM17/6107/UGR).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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