Background Current BTS/SIGN guidelines suggest the inclusion of behavioural interventions as part of the management for overweight patients with Obstructive Sleep Apnoea Syndrome (OSAS). Healthy lifestyle interventions are widely available in a variety of settings for other chronic diseases.
Our aims were to assess:
patients’ views and their experience with weight loss and lifestyle changes.
Internet and Information Technology (IT) access to investigate if a web-based lifestyle intervention would be feasible.
current clinical practice regarding healthy lifestyle advice.
Methods A questionnaire was developed to assess patients’ experience with lifestyle changes, their preferences and willingness to take part in a healthy lifestyle intervention, and their internet and IT usage. This was administered to patients with treated OSAS attending a sleep clinic. The MRC dyspnoea scale grade and Veterans Specific Activity Questionnaire (VSAQ)(1) were measured. Current practice regarding lifestyle advice and interventions, and serial weights were assessed by a case-note review of sequential overweight patients with treated OSAS attending a sleep clinic.
Results 112 patients with treated OSAS completed the survey (results shown in Table 1): 80.5% male, 76% aged 50 to 79 years, mean estimated BMI 35 kg m-2, median [IQR] MRC dyspnoea scale 3[2–3] and VSAQ score 5[3–7] indicating being unable to walk briskly. 75% of individuals had access to broadband Internet (Table 1) and over 40% would be interested in a web-based healthy lifestyle intervention. 33 case-notes were reviewed with a mean follow up of 5 years. 27/33 individuals had been given healthy lifestyle advice of which 24/27 was to lose weight. Only two individuals had been recommended to join a leisure programme. Weight remained unchanged over five years after diagnosis, ANOVA p = 0.90.
Conclusions Breathlessness causing reduced physical activity was commonly reported in overweight patients with OSAS. Weight loss is not currently achieved after simple advice from a healthcare professional, and advice or support regarding increasing physical activity is rarely provided. Further support with healthy lifestyle interventions should be explored, and attitudes and Internet access would favour development of a web-based intervention.
Myers et al. Am Heart J 2001;14: 1041–1046
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