Sleep Apnea Clinical Trial
Official title:
Mediterranean-type Diet for Older Adults With Obstructive Sleep Apnea: Randomized Clinical Trial - MedOOSA Project
The majority of the elderly present with sleep apnea and mortality is significantly higher in
this group. Sleep apnea runs the risk of developing diseases, especially hypertension and
cardiovascular disease, while the Mediterranean diet is associated with reduced risk.
No study evaluated the effect of the Mediterranean diet on the apnea and hypopnea index in
the elderly. Therefore, the present work intends to evaluate the effect of the intervention
with the Mediterranean diet on the apnea-hypopnea index in the elderly with moderate sleep
apnea.
The hypothesis study is that the elderly with moderately severe sleep apnea under a
Mediterranean-type diet will modify AHI in the short term, regardless of weight change, due
to changes in body volume and ingestion, especially those related to body water.
PRIMARY OBJECTIVE:
To evaluate the effect of the Mediterranean diet intervention on the apnea-hypopnea index in
the elderly with moderate-severe sleep apnea.
SECONDARY OBJECTIVES:
- To compare the effect of intervention with Mediterranean diet on the effect of low-fat
diet (control) on anthropometric variables (BMI, neck and waist circumferences) and
bioimpedance (body water, lean mass, fat mass).
- To compare the effect of the intervention with a diet of the Mediterranean type to the
effect of the intervention with a low-fat diet (control) on glycolipid profile,
C-reactive protein, Sodium, and Potassium.
- To compare the effect of the Mediterranean diet intervention on the effect of the
low-fat diet (control) on blood pressure: systolic, diastolic and heart rate measured in
24-hour ABPM.
PROCEDURES:
All variables will be measured equally in the two groups: Mediterranean diet and control
diet. The provision of extra virgin olive oil and oilseeds will be provided free to
participants randomized to the Mediterranean diet at visits 1 and 2 and participants
randomized to the control diet will receive nutritional guidelines. There will be no caloric
restriction for both groups, nor will there be any increase in physical activity.
All participants will be interviewed by a nutritionist and a nutritionist at the baseline and
at all subsequent visits, and the dietary guidelines will be given by the same nutritionist.
Evaluations with participants from both groups will be organized separately for each of the
groups. All participants will be instructed not to use multivitamins or antioxidant
supplements during the study period.
ASSESSMENT OF ADHERENCE TO THE MEDITERRANEAN DIET:
A questionnaire with 14 items (Annex 3) assessing adherence to the Mediterranean diet will be
used. A value of 0 (not compatible) or 1 (compatible) will be assigned to each item answered
on the diet. Higher scores will reflect better adherence to the diet. High adherence will be
set when matching at least 11 of the 14 items.
RANDOMIZATION:
The randomization to the diet group of the Mediterranean type or Diet Control will be
performed by withdrawing the envelope in groups of 4 following random numbers generated by
computer.
SAMPLE SIZE The sample size calculation is based on the study "Effect of Mediterranean diet
versus prudent diet combined with physical activity on OSAS: a randomized trial" 45. For a 5%
alpha error and 80% power, the calculated sample size was 24 patients in each group to detect
an effect size of 0.25 standard deviation. However, considering withdrawals, withdrawal of
consent, absenteeism, and case losses during the study period, up to 25 patients will be
evaluated in the Mediterranean diet group and 25 in the control diet group.
STATISTICAL ANALYSIS The demographic characteristics and other variables of interest of the
participants of the Mediterranean diet and Diet control groups will be compared using the
Student's t-test or the chi-square test. Paired t-test or non-parametric test will be
performed to compare measures at baseline and after two months of intervention within each
group. Differences of measures of interest will be determined between the groups using
covariance analysis (ANCOVA) controlled by the corresponding baseline levels, sex, and age or
by non-parametric test. The transformation to log for data that is not normally distributed
will be used. The significance of P <0.05 will be considered significant. The analyzes will
be performed with the IBM SPSS Statistics version 20 program.
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