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Consistent sleep apnea treatment lowers diabetes risk
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Adults with overweight or obesity, prediabetes and sleep apnea who receive overnight continuous positive airway pressure for 8 hours a night may experience improved glucose metabolism and insulin sensitivity, according to research in the American Journal of Respiratory and Critical Care Medicine.
In a randomized controlled, parallel group study, participants showed improved blood glucose control, improved insulin sensitivity, lower levels of the stress hormone norepinephrine and lower blood pressure after 2 weeks of monitored overnight continuous positive airway pressure (CPAP) use.
“Our findings suggest that CPAP treatment, if used for 8 hours per night, may provide cardiometabolic benefits in prediabetes, a potentially reversible state in which the development of overt diabetes and its cardiovascular complications could be prevented or delayed,” the researchers wrote.
Sushmita Pamidi, MD, a professor at McGill University in Montreal, and colleagues at other institutions analyzed data from 39 adults aged at least 45 years with overweight or obesity, sleep apnea and prediabetes randomly assigned 8-hour nightly CPAP treatment or an oral placebo taken 30 minutes before bedtime. Researchers recorded sleep and supervised CPAP adherence each night in a laboratory setting and assessed glucose metabolism at baseline and after 2 weeks of treatment using both oral and IV glucose tolerance tests. All participants engaged in normal activities during the day.
After 2 weeks, the overall glucose response was reduced (P = .03) and insulin sensitivity was improved (P = .04) with the use of CPAP vs. placebo. In addition, norepinephrine levels and 24-hour BP were reduced with CPAP vs. placebo.
“After 2 weeks of treatment, fasting insulin levels were significantly reduced in the group receiving CPAP compared to the change in the placebo group, but the change in 2-hour insulin levels did not differ between the groups,” the researchers wrote. “Insulin sensitivity estimated by the IV [glucose tolerance test] was significantly improved after CPAP treatment as compared to treatment effect with placebo.”
Previous studies regarding CPAP use have shown minimal improvement regarding glucose metabolism, but the average duration of CPAP use during those trials ranged from 3.3 to 6.2 hours, according to researchers. The results show that extending CPAP use to 8 hours per night can have a metabolic benefit and reduce diabetes risk, according to researchers.
“Although 8 hours of CPAP per night can be difficult to achieve in real life, our results should provide a strong incentive for anyone with sleep apnea, especially prediabetic individuals, to improve adherence to their treatment for cardiometabolic risk reduction,” Pamidi said in a press release. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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