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Sibutramine versus continuous positive airway pressure in obese obstructive sleep apnoea patients

¹ Institut universitaire de cardiologie et de pneumologie de Québec, and, Faculties of ² Pharmacy, and ³ Medicine, Laval University, Quebec, QC, Canada.

CORRESPONDENCE: F. Sériès, Institut universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec, QC, G1V 4G5, Canada. E-mail: Frederic.Series{at}fmed.ulaval.ca

Keywords: Continuous positive airway pressure, obesity, sibutramine, sleep apnoea, weight loss

Received: November 5, 2008
Accepted March 29, 2009

The aim of the present study was to compare the efficacy of 1 yr of sibutramine-induced weight loss versus continuous positive airway pressure (CPAP) treatment on sleep-disordered breathing, cardiac autonomic function and systemic blood pressure in obese patients with obstructive sleep apnoea.

Subjects with a body mass index of 30 kg·m^–2 without previous treatment for obstructive sleep apnoea underwent either sibutramine (n = 22) or CPAP (n = 18) treatment for 1 yr.

Sibutramine induced a 5.4±1.4 kg decrease in body weight compared to the CPAP group, in which no changes in anthropometric variables were observed. The CPAP treatment improved all sleep and respiratory variables, whereas sibutramine-induced weight loss improved only nocturnal arterial oxygen saturation profile. Only CPAP treatment improved night-time systolic and diastolic blood pressure and 24-h and daytime ambulatory diastolic blood pressure. Sibutramine-induced weight loss had no impact on indices of heart rate variability, whereas CPAP treatment increased daytime time domain indices.

CPAP treatment for 1 yr had beneficial impacts on nocturnal breathing disturbances, and improved nocturnal oxygenation, night-time systolic and diastolic blood pressure, and daytime cardiac parasympathetic modulation. Sibutramine did not improve sleep-disordered breathing, systemic blood pressure or heart rate variability. There were no adverse effects, such as increment in blood pressure or arrhythmias, associated with this treatment regimen.