Table 2.
Summary of energy expenditure via indirect calorimetry in OSA patients.
| Author, year (reference#) [NOS rating] |
Participants | AHI cutoff, events/h |
Sample size |
Age (SD), years |
BMI (SD), kg/m2 |
Design | Outcomes | Main findings |
|---|---|---|---|---|---|---|---|---|
| Beitler et al., 2014 [43] [*******] |
OSA Cx |
≥15 <15 |
n = 15 n = 19 |
47.9 (11.5) 34.3 (12.0) |
32.2 (7.8) 28.8 (6.5) |
Btw-group comparison |
IC-hood for fasted RMR in AM |
↔ RMR between OSA and Cx (mean [SD]: 1650 [262] vs. 1604 [302] kcal/day) |
| de Jonge et al., 2012 [43] [N/A] |
No OSA to OSA |
x̄ RDI = 12.6 | n = 126 | 40.5 (6.9) | 38.6 (6.5) | regression | IC-hood for fasted RMR in AM |
RMR (corrected for FFM, age, sex) positively associated with RDI (r = 0.32, p = 0.002) |
| Fekete et al., 2015 [38] [*****] |
OSA Cx |
≥15a N/R |
n = 92 n = 19 |
45.3 (12.8) 50.8 (11.7) |
33.2 (4.7) 28.3 (3.1) |
Btw-group comparison |
IC-mask for pre-sleep and AM RMR |
↑ RMR in OSA vs. Cx pre-sleep (mean [SD]: 1959.8 [969.9] vs. 1380.7 [488.4] kcal) and AM (mean [SD]: 1754.1 [734.2] vs. 1308.8 [557.4] kcal) and after correcting for LBM pre-sleep (mean [SD]: 29.6 [12] vs. 22.9 [7.9] kcal/kg) and AM (mean [SD]: 26.4 [9.6] vs. 21.6 [9] kcal/kg) |
| Hins et al. 2006 [47] [N/A] |
OSA Cx |
N/R N/R |
n = 8 n = 86 |
51.4 (7.9) 40.2 (12.4) |
43.2 (7.5) 28.7 (5.3) |
regression | WRIC for 24-h EE and SMR; Cx data used as reference to determine predicted values in OSA |
Negative relationship between nocturnal desaturation and difference in predicted and measured 24-h EE (r = −0.74, p = 0.04) and SMR (r = −0.68, p = 0.08) |
| Kezirian et al. 2008 [45] [N/A] |
No OSA to OSA |
x̄ = 25.4 | n = 212 | 42.3 (12.6) | 28.3 (7.3) | regression | IC-mouthpiece for fasted RMR |
RMR (corrected for BMI, age, sex) positively associated with RDI (coefficient estimate [95% CI]: 2.69 [0.63 to 4.74], p = 0.01) |
| Lin et al., 2002 [39] [*******] |
OSA Cx |
RDI ≥20 N/R |
n = 25 n = 15 |
41.0 (6.0) 38.0 (5.0) |
29.8 (2.5) 28.4 (2.2) |
Btw-group comparison |
IC-hood for fasted RMR in AM, and SMR |
↔ RMR (corrected for weight) between OSA and Cx (mean [SD]: 0.81 [0.06] vs. 0.78 [0.05] kcal/kg/h) ↑ SMR (corrected for RMR) in OSA vs. Cx (mean [SD]: 1.02 [0.06] vs. 0.88 [0.05]) |
| Major et al., 2007 [46] [*******] |
OSA | N/R, x̄ = ~35.0 |
n = 24 | x̄ = ~49.0 | x̄ = ~32.8 | regression | WRIC for 24-h EE and SMR | 24-h EE (r = −0.46, p < 0.05) and SMR (corrected for body weight; r = −0.48, p < 0.05) negatively associated with total recording time with SaO2 <90% |
| Ryan et al., 1995 [40] [******] |
OSA Cx |
>30 <20 |
n = 14 n = 14 |
45.0 (10.0) 46.0 (8.0) |
39.8 (6.5) 34.2 (10.9) |
Btw-group comparison |
IC-hood for fasted RMR in AM |
↑ RMR in OSA vs. Cx (mean [SD]: 2140 [301] vs. 1813 [256] kcal/day), but not after correcting for LBM (mean [SD]: 26.6 [3.3] vs. 28.1 [3.6] kcal/kg) |
| Stenlof et al., 1996 [41] [*******] |
OSA Snoring Cx |
RDI >30 N/R |
n = 5 n = 6 |
46.0 (13.0) 50.0 (9.0) |
34.0 (7.0) 28.0 1.7) |
Btw-group comparison |
WRIC for 24-h EE, SMR, and fasted RMR in AM |
↑ 24-h EE (mean [SD]: 39.2 [3.0] vs. 33.9 [2.7] kcal/d/kg) and RMR (mean [SD]: 31.1 [2.7] vs. 25.4 [2.8] kcal/d/kg) but not SMR (mean [SD]: 32.4 [4.1] vs. 26.3 [1.9] kcal/d/kg), in OSA vs. Cx after correcting for FFM |
| Ucok et al., 2011 [42] [******] |
OSA Snoring Cx |
≥10 <10 |
n = 51 n = 47 |
48.0 (8.0) 49.7 (10.0) |
32.5 (5.5) 32.3 (6.1) |
Btw-group comparison |
IC-mask for fasted RMR in AM |
↑ RMR in OSA vs. Cx (mean [SD]: 1676.4 [600] vs. 1332.8 [285.2] kcal/day) |
AHI: apnea-hypopnea index; AM: morning; BMI: body mass index; CI: confidence interval; Cx: control; EE: energy expenditure; FFM: fat-free mass; IC: indirect calorimetry; LBM: lean-body mass; NOS: Newcastle-Ottawa scale (up to nine stars); OSA: obstructive sleep apnea; RDI: respiratory disturbance index; RMR: resting metabolic rate; SaO2: arterial oxygen saturation; SD: standard deviation; SMR: sleeping metabolic rate; WRIC: whole-room indirect calorimetry; ↑: significant increase; ↓: significant decrease; ↔: no difference.
a
Indicates inclusion was AHI ≥15 with no symptoms or ≥5 with symptoms (daytime sleepiness, poor sleep, snoring/gasping).