0817 ADHERENCE TO CPAP TREATMENT IN WOMEN WITH OBSTRUCTIVE SLEEP APNEA

Objective: Despite evidence of a relationship between obstructive sleep apnea (OSA), metabolic dysregulation and diabetes mellitus (DM), it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and DM risk in patients with cardiovascular disease (CVD) and OSA. Research Design and Methods: Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea Cardiovascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus Usual Care, or Usual Care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, and six months, two- and four years, and incident diabetes diagnoses recorded. Results: Median follow-up was 4.3 years. In those with pre-existing DM (n=274), there was no significant difference between CPAP and Usual Care groups in serum glucose, HbA1c or anti-diabetic medications during follow-up. There were also no significant between-group differences in participants with pre-diabetes (n=452), nor in new diagnoses of DM. Interaction testing suggested that women with diabetes did poorly in the Usual Care group while their counterparts on CPAP therapy remained stable. Conclusions: Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affected glycemic control in those with diabetes or pre-diabetes, or DM risk over standard of care treatment. The potential differential effect according to sex deserves further investigation.

Download Full-text

I’m sleeping my day away. Improving diabetes self-management using CPAP treatment in patients with obstructive sleep apnea and type 2 diabetes: A qualitative explorative study (Preprint)

JMIR Formative Research ◽

10.2196/27062 ◽

2021 ◽

Author(s):

Ditte Hjorth Laursen ◽

Gitte Rom ◽

Anne Margareta Banghoej ◽

Lise Tarnow ◽

Lone Schou

Keyword(s):

Type 2 Diabetes ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Self Management ◽

Explorative Study ◽

Cpap Treatment ◽

Obstructive Sleep

Download Full-text

Does CPAP treatment improve blood pressure in patients with obstructive sleep apnea and hypertension?

Evidence-Based Practice ◽

10.1097/ebp.0000000000000744 ◽

2020 ◽

Vol 23 (8) ◽

pp. 34-36 ◽

Cited By ~ 1

Author(s):

Firaz Chaudhry ◽

Julia Fashner

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cpap Treatment ◽

Obstructive Sleep

Download Full-text

Obstructive Sleep Apnea and CPAP Treatment Response in Patients with Non Alcoholic Fatty Liver Disease

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4705 ◽

2020 ◽

Author(s):

D.S. Hui ◽

S. Ng ◽

G. Wong ◽

W. Chu ◽

F. Ko ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Liver Disease ◽

Sleep Apnea ◽

Fatty Liver ◽

Treatment Response ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Cpap Treatment ◽

Obstructive Sleep ◽

Alcoholic Fatty Liver Disease

Download Full-text

0054 Metabolite Profiles of Obstructive Sleep Apnea Distinguishes Cases from Controls and Improve With CPAP

SLEEP ◽

10.1093/sleep/zsaa056.052 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A21-A22

Author(s):

A Sengupta ◽

D C Lim ◽

B T Keenan ◽

L Keele ◽

A Pack ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Methionine Sulfoxide ◽

Ultra Performance Liquid Chromatography ◽

Healthy Controls ◽

Serum Samples ◽

Metabolomics Data ◽

Cpap Treatment ◽

Clinical Biomarkers ◽

Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is a common sleep breathing disorder with significant public health consequences. Despite this, no clinically available objective molecular biomarkers to diagnose, risk stratify and quantify treatment efficiency exist. To this end, high-throughput metabolomics data could serve as a valuable quantitative tool. Methods We designed a pilot study to investigate the metabolomic effects of OSA and CPAP treatment. Blood serum samples were collected from OSA patients and healthy controls matched with respect to age (±5 years), BMI (±2.5 kg/m2) and gender (N = 20/group). Samples from OSA patients were obtained before and after continuous positive airway pressure (CPAP) treatment. Polar metabolites were analyzed using a targeted ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) metabolomics technique. Results Supervised multivariate analysis using serum metabolic values of OSA patients and healthy controls showed a significantly different overall metabolic profile between the two groups (orthogonal partial least squares discriminant analysis [OPLS-DA] Q2=0.25, p=0.04). Acetylornithine, choline, cytidine, dodecenoylcarnitine, methionine sulfoxide and 3-indoxylsulfate were among the most perturbed metabolites. Major metabolic pathways altered in the OSA patients were methionine and phospholipid metabolism, as well as gut microbial co-metabolism. Lysophosphatidylcholine (16:0), a phospholipid metabolite, demonstrated significant linear association with improved oxygen saturation nadir post CPAP treatment (R2 = 0.57), suggesting the metabolic features may be used as prognostic clinical biomarkers. Conclusion These results suggest that OSA significantly impacts blood metabolites, which could potentially be used to establish OSA biomarkers. Moreover, specific metabolic features are associated with post CPAP improvement, such as phospholipids, suggesting a functional association of these metabolites that may help us understand the heterogeneity of OSA. Overall, these results demonstrate the potential of metabolic profiling to develop quantitative molecular markers of OSA. Further studies are underway to validate these findings and investigate the utility of metabolic profiles to objectively measure CPAP efficacy. Support The work was supported by the program project grant P01 HL094307.

Download Full-text