CPAP, Weight Loss, or Both for Obstructive Sleep Apnea
CPAP, Weight Loss, or Both for Obstructive Sleep Apnea Julio A. Chirinos, M.D., Ph.D., Indira Gurubhagavatula, M.D., Karen Teff, Ph.D., Daniel J. Rader, M.D., Thomas A. Wadden, Ph.D., Raymond Townsend, M.D., Gary D. Foster, Ph.D., Greg Maislin, M.S., M.A., Hassam Saif, M.D., Preston Broderick, M.A., Jesse Chittams, M.S., Alexandra L. Hanlon, Ph.D., and Allan I. Pack, M.B., Ch.B., Ph.D. N Engl J Med 2014; 370:2265-2275 June 12, 2014 DOI: 10.1056/NEJMoa1306187 BACKGROUND Obesity and obstructive sleep apnea tend to coexist and are associated with inflammation, insulin resistance, dyslipidemia, and high blood pressure, but their causal relation to these abnormalities is unclear. METHODS We randomly assigned 181 patients with obesity, moderate-to-severe obstructive sleep apnea, and serum levels of C-reactive protein (CRP) greater than 1.0 mg per liter to receive treatment with continuous positive airway pressure (CPAP), a weight-loss intervention, or CPAP plus ...