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CPAP improved outcomes, health status in obstructive sleep apnea, diabetes
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The use of continuous positive airway pressure to treat patients with obstructive sleep apnea and type 2 diabetes improved key outcomes and increased health status, according to research published in Diabetes Care.
Continuous positive airway pressure (CPAP) to manage obstructive sleep apnea (OSA) also proved cost-effective for the National Health Service (NHS) in a study by researchers in the United Kingdom and could hold potential for treatment modification.
“This study’s findings should provide a framework for a randomized controlled trial comparing the use of CPAP in the management of OSA patients with type 2 diabetes to prospectively measure a range of clinical outcomes and health-related quality of life in combination with cost-effectiveness metrics,” the researchers wrote.
Julian F. Guest, PhD, of Catalyst Health Economics Consultants and the School of Biomedical Sciences at King’s College, and colleagues conducted a case-control study with patients randomly selected from The Health Improvement Network (THIN) database.
By age and sex, the researchers matched 150 patients with OSA and type 2 diabetes treated with CPAP with 150 patients with the same health conditions but not receiving CPAP. Total cost to the NHS and patient management outcomes over 5 years were estimated, along with the cost-effectiveness of treatment vs. no treatment.
Patients treated with CPAP demonstrated significant blood pressure reductions by the study’s end and increasingly lower HbA1c levels during 5 consecutive years compared with patients not treated; HbA1c measurements were 8.2% (66 mmol/mol) for patients with CPAP vs. 12.1% (108.4 mmol/mol) for patients in the control group (P<.03).
Patients experienced significant increases in health status with CPAP, amounting to 0.27 quality-adjusted life years per patient during 5 years (P<.001). NHS management costs also increased, at a rate of 4,141 British pounds ($6,921) per patient during the same period. The cost for every quality-adjusted life year gained with CPAP was assessed at 15,337 British pounds.
The researchers noted limitations of the data set, including patients not being randomly assigned to treatment type, severity of OSA not included as matching criteria, time from diagnosis to treatment, compliance attitudes and lack of stratification for use and costs.
However, the researchers said they remain hopeful about the possibility of CPAP to potentially facilitate glycemic control in patients with OSA and type 2 diabetes.
“This observation has the potential to alter treatment decisions, particularly if confirmed in a prospective trial,” they said.
Disclosure: This study was funded by an unrestricted research grant from ResMed in Martinsried, Germany.
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