Lifestyle changes and weight loss are cornerstones of OSA therapy. Few studies have examined the role of changes in diet quality or exercise in this disease. Since there is a complex, rather than simple weight-load pathogenesis of OSA, it would be interesting to consider how altering dietary quality might affect OSA severity beyond simply facilitating weight loss. The effectiveness of different diets in OSA patients beyond the potential reductions on upper airway mechanical loads needs to be explored. Investigating the role of unrestricted low-carbohydrate and Mediterranean diets in upper airway neuromuscular control and taking into account the confounding effect of weight change could be an approach.
Future studies should identify the optimal exercise programme, characterised by type, frequency and intensity of exercise, length of programme, duration of individual supervised sessions and number of sessions per week for OSA treatment. These studies should focus not only on a single mechanism responsible for improvements in OSA following exercise training, but on several possible mechanisms.