Guideline for the Management of Obesity in Adult Patients With Obstructive Sleep Apnea

초록

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder strongly influenced by obesity, the most significant modifiable risk factor. Effective weight management is therefore essential for optimal OSA care. This guideline aims to provide updated, evidence-based recommendations for the evaluation and management of obesity in adults with obstructive sleep apnea (OSA), incorporating recent advances in lifestyle, pharmacologic, and surgical interventions. The Korean Society of Sleep and Breathing convened a multidisciplinary panel. A systematic literature search was performed across major databases through 2025. Evidence was appraised using GRADE, and recommendations were formulated through consensus using the Evidence-to-Decision framework. Eight statements were developed. Key recommendations include recognizing obesity as a major risk factor, routinely assessing overweight and obesity, and implementing structured weight reduction through diet, exercise, and behavioral therapy. Glucagon-like peptide-1 receptor agonists are recommended when lifestyle interventions are insufficient, and bariatric/metabolic surgery is advised for severe obesity unresponsive to nonsurgical treatment. Weight loss improves apnea-hypopnea index, symptoms, and cardiometabolic markers and may reduce positive airway pressure needs. Continued follow-up is recommended even after clinical improvement. Weight management is a core component of OSA treatment. This guideline offers practical, evidence-based strategies to support clinicians in delivering effective obesity-focused care for adults with OSA.

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