The effect of an intensive lifestyle intervention on sleep outcomes in type 2 diabetic patients: Secondary analyses from the randomised U-TURN trial

This secondary analysis examined the effect of a 12 months intensive exercise-based life-style intervention (U-TURN) on obstructive sleep apnoea (OSA) severity measured with the apnoea-hypopnoea index (AHI), and its effect on sleep quality. Inclusion criteria: 1) T2D < 10 years, 2) BMI of 25 to 40 kg/m2, 3) taking ≤2 glucose-lowering medications. In addition to exercise and diet, the intervention included recommendations of high sleep hygiene. Sleep outcomes were determined with cardio-respiratory monitoring, the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). Participants included in the analysis: U-TURN, n = 61; standard care, n = 31. At 12-month follow-up, there was no difference in the change in AHI between the U-TURN and standard care groups (0.10 [95% CI, -1.40 - 2.20], p = 0.703). Likewise, the groups were similar with respect to the oxygenation of the blood, snoring, average and lowest O2, and periodic limb movement. The changes in ESS and PSQI did not differ between the groups (ESS: -0.56 [-1.62 - 0.50]; PSQI: -0.04 [-1.04 - 0.96]). In conclusion, no significant effect was observed, highlighting the complexity of OSA and underscoring the need for future research to determine the magnitude of weight loss re-quired and to elucidate the role of sex differences in effective treatment strategies.