• Stuart F Quan, Rohit Budhiraja, Denise P Clarke, James L Goodwin, Daniel J Gottlieb, Deborah A Nichols, Richard D Simon, Terry W Smith, James K Walsh, and Clete A Kushida.
• Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA ; Arizona Respiratory Center, University of Arizona, Tucson, AZ.
• J Clin Sleep Med. 2013 Oct 15;9(10):989-93.

Study ObjectiveTo determine the impact of continuous positive airway pressure (CPAP) on weight change in persons with obstructive sleep apnea (OSA).Design Setting And ParticipantsThe Apnea Positive Pressure Long-term Efficacy Study (APPLES) was a 6-month, randomized, double-blinded sham-controlled multicenter clinical trial conducted at 5 sites in the United States. Of 1,105 participants with an apnea hypopnea index ≥ 10 events/ hour initially randomized, 812 had body weight measured at baseline and after 6 months of study.InterventionCPAP or Sham CPAP.MeasurementsBody weight, height, hours of CPAP or Sham CPAP use, Epworth Sleepiness Scale score.ResultsParticipants randomized to CPAP gained 0.35 ± 5.01 kg, whereas those on Sham CPAP lost 0.70 ± 4.03 kg (mean ± SD, p = 0.001). Amount of weight gain with CPAP was related to hours of device adherence, with each hour per night of use predicting a 0.42 kg increase in weight. This association was not noted in the Sham CPAP group. CPAP participants who used their device ≥ 4 h per night on ≥ 70% of nights gained the most weight over 6 months in comparison to non-adherent CPAP participants (1.0 ± 5.3 vs. -0.3 ± 5.0 kg, p = 0.014).ConclusionsOSA patients using CPAP may gain a modest amount of weight with the greatest weight gain found in those most compliant with CPAP.CommentaryA commentary on this article appears in this issue on page 995.CitationQuan SF; Budhiraja R; Clarke DP; Goodwin JL; Gottlieb DJ; Nichols DA; Simon RD; Smith TW; Walsh JK; Kushida CA. Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea.

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