Designing a program to support weight loss for patients attending the sleep medicine clinic: a qualitative study

Study Objectives: Excess body weight is the most important risk factor in sleep-disordered breathing. Weight loss is a treatment alternative to positive airway pressure therapy, but there is a knowledge gap of what is feasible, acceptable, and sustainable in this population. We seek to add the voices of sleep medicine patients and providers to the medical literature to understand what makes this population unique when considering weight loss, and what we can do differently to create more sustainable weight loss interventions. Methods: We conducted one-on-one semistructured interviews with 12 patients with obstructive sleep apnea/obesity hypoventilation syndrome and obesity and with 9 sleep medicine providers regarding previous weight loss efforts, perceptions of barriers to and facilitators of weight loss, and potential components of a program to support those with sleep apnea and excess weight. Results: Patients indicated they appreciated direct conversation with their sleep physician regarding weight loss and providers felt the patient population was generally very receptive to weight loss conversations. Patients emphasized the most important aspects of a future weight loss program would be personalized diet, exercise, accountability, integration of technology, and an individualized approach to addressing the psychological aspects of eating. Conclusions: This is a unique population of patients who are very receptive to conversations about weight loss. We plan to use this data to inform a future weight loss program based in health coaching to address the specific needs of this population.