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Cited by 583Obstructive Sleep Apnea ResearchSleep and related disordersDiabetes, Cardiovascular Risks, and Lipoproteins

Continuous Positive Airway Pressure Treatment Rapidly Improves Insulin Sensitivity in Patients with Obstructive Sleep Apnea Syndrome

Harsch, Igor A., Schahin, Simin Pour, Radespiel-Tröger, Martin, Weintz, Oliver, Jahreiß, Holger, Fuchs, Florian S., Wiest, Gunther H., Hahn, Eckhart G. +3 more·2004·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/rccm.200302-206oc
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Abstract

The obstructive sleep apnea syndrome is typically associated with conditions known to increase insulin resistance as hypertension, obesity, and diabetes. We investigated whether obstructive sleep apnea itself is an independent risk factor for increased insulin resistance and whether continuous positive airway pressure (CPAP) treatment improves insulin sensitivity. Forty patients (apnea–hypopnea index > 20) were treated with CPAP. Before, 2 days after, and after 3 months of effective CPAP treatment, hyperinsulinemic euglycemic clamp studies were performed. Insulin sensitivity significantly increased after 2 days (5.75 ± 4.20 baseline versus 6.79 ± 4.91 μmol/kg · min; p = 0.003) and remained stable after 3 months of treatment. The improvement in insulin sensitivity after 2 days was much greater in patients with a body mass index less than 30 kg/m2 than in more obese patients. The improved insulin sensitivity after 2 nights of treatment may reflect a decreasing sympathetic activity, indicating that sleep apnea is an independent risk factor for increased insulin resistance. The effect of CPAP on insulin sensitivity is smaller in obese patients than in nonobese patients, suggesting that in obese individuals insulin sensitivity is mainly determined by obesity and, to a smaller extent, by sleep apnea.

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Crossref · 10.1164/rccm.200302-206oc

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  • Four positive studies used the hyperinsulinemic-euglycemic clamp, two used continuous glucose monitoring, and one used the minimal model estimate from an intravenous glucose tolerance test.

    “Methodological differences may also account for the variability of results obtained: four positive studies relied on the hyperinsulinemic–euglycemic clamp technique to assess SI [15, 65, 66, 142], which is considered the gold standard to evaluate SI; another two used continuous glucose monitoring (CGMS) [4, 205], which provides 288 readings of interstitial glucose levels per 24 h (every 5 min) and”

    From Sleep and metabolic function (2012) · cites this paper as [65]

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Authors
Harsch, I. A., Schahin, S. P., Radespiel-Tröger, M., Weintz, O., Jahreiß, H., Fuchs, F. S., Wiest, G. H., Hahn, E. G., Lohmann, T., Konturek, P. C., & Ficker, J. H.
Affiliations
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Department of Medicine I; Department of Medical Informatics, Biometrics, and Epidemiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen; Department of Medicine 3, Klinikum Nürnberg, Nuremberg, Germany
ORCID
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
2004-01
Volume
169
Issue
2
Pages
156-162
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
DOI
10.1164/rccm.200302-206oc
OpenAlex
W2151147308
Cited by
583
References
58
Citations by year
2026: 4 · 2025: 6 · 2024: 6 · 2023: 26 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 12 · 2018: 22 · 2017: 19 · 2016: 27 · 2015: 23 · 2014: 30 · 2013: 27 · 2012: 29
FWCI
17.19
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
obstructive sleep apnea, continuous positive airway pressure, insulin sensitivity, insulin resistance, hyperinsulinemic-euglycemic clamp, obesity, body mass index, sympathetic activity, diabetes risk factors
MeSH terms
Female, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Risk Factors, Glucose Clamp Technique, Body Mass Index, Sleep Apnea, Obstructive, Leptin, Continuous Positive Airway Pressure

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