Diuretic or sodium-restricted diet for obstructive sleep apnea—a randomized trial

Study answer

What this study found

After 1 week, AHI reductions differed by group (p = 0.001). Diuretic group: ΔAHI −7.3 events/hour (−14.4%); sodium-restricted diet group: ΔAHI −10.7 events/hour (−22.3%); placebo: minimal change. None achieved normal AHI. Diet improved Epworth Sleepiness Scale and neck circumference; total body water decreased in both intervention groups (diuretic −2.2 L; diet −1.0 L). 24-h urinary sodium decreased most with the diet. Conclusion: Reducing bodily fluid content modestly lowers OSA frequency in men with severe OSA, implying rostral fluid displacement contributes but is not the sole determinant;…

Study & population

Three-arm, parallel, placebo-controlled randomized clinical trial in 54 men aged 18–60 with severe obstructive sleep apnea (AHI >30/h; BMI <35 kg/m^2).

Intervention

Spironolactone 100 mg + furosemide 20 mg daily for 7 days (taken in the morning).

Key limitation

Short duration (1 week); small, male-only sample (n=54) limits generalizability; Diet not blinded; home sleep apnea testing used instead of full polysomnography; bioelectrical impedance for total body water has limited accuracy; no long-term outcomes.

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Original abstract