The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea

Objective: Obstructive sleep apnoea (OSA) occurs frequently in obese patients and may be reversible with weight loss. Obstructive sleep apnoea and obesity are both independent risk factors for hypertension and increased sympathetic activity. Sibutramine has been increasingly used in the management of obesity, but is relatively contraindicated in patients with hypertension. No studies have investigated the effect of sibutramine on OSA, blood pressure and heart rate. We aimed to assess the changes in OSA and cardiovascular parameters in obese men with OSA enrolled in a sibutramine-assisted weight loss programme (SIB-WL). Design: Open uncontrolled cohort study of obese male subjects with OSA in an SIB-WL. Subjects: Eighty-seven obese (body mass index = 34.2 +/- 2.8 kg/m(2)) middle-aged (46.3 +/- 9.3 years) male subjects with symptomatic OSA (Epworth score 13.4 +/- 3.6; respiratory disturbance index (RDI) 46.0 +/- 23.1 events/h) completed the study. Results: At 6 months, there was significant weight loss (8.3 +/- 4.7 kg, P < 0.0001), as well as a reduction in waist and neck circumference and sagittal height (all P < 0.0001). These changes were accompanied by a reduction in OSA severity (RDI fell by 16.3 +/- 19.4 events/ h and Epworth score by 4.5 +/- 4.6), both P < 0.0001). There was no significant change to systolic (P = 0.07) or diastolic blood pressure (P = 0.87); however, there was a mild rise in resting heart rate (P < 0.0001). Conclusion: Moderate (similar to 10%) weight loss with SIB-WL results in improvement in OSA severity without increase in blood pressure in closely monitored OSA subjects.