| Title: |
Effect of a Self-Directed Lifestyle-based Weight Management Program Among Patients With Comorbid COPD and Sleep Apnea |
| Authors: |
Leonhard, A.G.; Coggeshall, S.; Gleason, E.; Margaret, C.; Barón, A.; Barjaktarevic, I.; Bascom, R.; Bon, J.; Comellas, A.P.; Diaz, P.T.; Hanania, N.A.; Han, M.K.; Hansel, N.N.; Hee Wai, T.; Hunter-Merrill, R.; Krishnan, J.A.; Lazarus, S.C.; Ma, J.; Maddipati, V.; Mador, M.J.J.; Make, B.J.; Mcevoy, C.E.; Meldrum, C.A.; Millard, M.W.; Moy, M.L.; Pirozzi, C.S.; Robert, P.; Que, L.G.; Reed, R.M.; Sciurba, F.C.; Sethi, S.; Simonelli, P.F.; Sumino, K.; Tiwari, A.; Voelker, K.G.; Wendt, C.H.; Wisniewski, S.R.; Au, D.H.; Donovan, L.M.; Feemster, L.C. |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 211, issue Supplement_1, page A1040-A1040 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Rationale: Excess weight contributes to impaired physical function among individuals with chronic obstructive pulmonary disease (COPD) and comorbid sleep apnea. Self-directed lifestyle-based weight management programs are an accessible option to promote weight loss and improve physical function, but their effectiveness in this population is unclear. We sought to test whether a self-directed lifestyle program improves 6-minute walk test (6MWT) distance among individuals with COPD and comorbid sleep apnea. Methods: INSIGHT-COPD was a randomized trial to test whether a self-directed video-based lifestyle intervention would lead to better physical function in participants with excess weight and COPD. We performed a retrospective subset analysis restricted to participants with a self-reported clinician-diagnosis of sleep apnea. Our primary outcome was between-group differences for change in 6MWT distance, which we measured using a linear mixed effects model. We also assessed secondary outcomes including weight and SF-12 physical function related quality of life. Finally, we assessed whether participants met meaningful thresholds for improvement and decline in 6MWT distance (30m) and weight loss (5% total body weight) using generalized linear regression models for binary outcomes. Results: Among the 684 participants randomized in INSIGHT-COPD, 285 had self-reported sleep apnea (141 randomized to intervention, 144 to control). At 12 months, those randomized to intervention could walk further relative to those randomized to control (adjusted between group difference for 6MWT distance +25.5 m [95% CI 8.2-42.9 m] for individuals with OSA in the intervention group compared to the control group). We did not observe a between-group difference in the likelihood of achieving meaningful improvement in 6MWT distance, though fewer intervention participants experienced a meaningful decline in 6MWT (Figure). Intervention participants also experienced a greater reduction in weight, (adjusted between-group difference of -2.4 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/ajrccm.2025.211.abstracts.a1040 |
| Availability: |
https://doi.org/10.1164/ajrccm.2025.211.abstracts.a1040; https://academic.oup.com/ajrccm/article-pdf/211/Supplement_1/A1040/67027103/ajrccm_211_abstracts_a1040.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.AA8CB7EA |
| Database: |
BASE |