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Cited by 181Obstructive Sleep Apnea ResearchSleep and related disordersNeuroscience of respiration and sleep

A Controlled Trial of CPAP Therapy on Metabolic Control in Individuals with Impaired Glucose Tolerance and Sleep Apnea

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Weinstock, Tanya G., Wang, Xuelei, Rueschman, Michael, Ismail-Beigi, Faramarz, Aylor, Joan, Babineau, Denise C., Mehra, Reena, Redline, Susan·2012·Sleep
DOI 10.5665/sleep.1816PMC PMC3321420
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Abstract

STUDY OBJECTIVES: To address whether treatment of sleep apnea improves glucose tolerance. DESIGN: Randomized, double-blind crossover study. SETTING: Sleep clinic referrals. PATIENTS: 50 subjects with moderate to severe sleep apnea (AHI > 15) and impaired glucose tolerance. INTERVENTIONS: Subjects were randomized to 8 weeks of CPAP or sham CPAP, followed by the alternate therapy after a one-month washout. After each treatment, subjects underwent 2-hour OGTT, polysomnography, actigraphy, and measurements of indices of glucose control. MEASUREMENTS AND RESULTS: The primary outcome was normalization of the mean 2-h OGTT; a secondary outcome was improvement in the Insulin Sensitivity Index (ISI (0,120). Subjects were 42% men, mean age of 54 (10), BMI of 39 (8), and AHI of 44 (27). Baseline fasting glucose was 104 (12), and mean 2-h OGTT was 110 (57) mg/dL. Seven subjects normalized their mean 2-h OGTT after CPAP but not after sham CPAP, while 5 subjects normalized after sham CPAP but not after CPAP. Overall, there was no improvement in ISI (0,120) between CPAP and sham CPAP (3.6%; 95% CI: [-2.2%, 9.7%]; P = 0.22). However, in those subjects with baseline AHI ≥ 30 (n = 25), there was a 13.3% (95% CI: [5.2%, 22.1%]; P < 0.001) improvement in ISI (0,120) and a 28.7% (95%CI: [-46.5%, -10.9%], P = 0.002) reduction in the 2-h insulin level after CPAP compared to sham CPAP. CONCLUSIONS: This study did not show that IGT normalizes after CPAP in subjects with moderate sleep apnea and obesity. However, insulin sensitivity improved in those with AHI ≥ 30, suggesting beneficial metabolic effects of CPAP in severe sleep apnea. Clinical trials information: ClinicalTrials.gov Identifier: NCT01385995.

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  1. [6]6. Brooks B, Cistulli PA, Borkman M, et al. Obstructive sleep apnea in obese non-insulin-dependent diabetic patients: effect of continuous positive air- way pressure treatment on insulin responsiveness. The Journal of clinical endocrinology and metabolism 1994;79:1681-5.

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Authors
Weinstock, T. G., Wang, X., Rueschman, M., Ismail-Beigi, F., Aylor, J., Babineau, D. C., Mehra, R., & Redline, S.
Affiliations
  • Brigham and Women's Hospital (US)
  • Case Western Reserve University (US)
Corresponding author
Redline, Susan
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2012-05
Volume
35
Issue
5
Pages
617-625
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.5665/sleep.1816
PMC
PMC3321420
OpenAlex
W2081226646
Cited by
181
References
62
Citations by year
2026: 3 · 2025: 7 · 2024: 4 · 2023: 7 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 10 · 2018: 20 · 2017: 18 · 2016: 15 · 2015: 29 · 2014: 18 · 2013: 19 · 2012: 7
FWCI
15.66
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Brigham and Women's Hospital
  • Case Western Reserve University (UL1RR024989)
  • National Institutes of Health (RR024989)
  • National Heart, Lung, and Blood Institute (R01HL075077, HL075077)
  • National Center for Research Resources (UL1RR024989)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
CPAP therapy, sleep apnea, impaired glucose tolerance, insulin sensitivity, insulin resistance, glucose tolerance, apnea-hypopnea index, obesity, metabolic control, sham CPAP
MeSH terms
Blood Glucose, Double-Blind Method, Female, Glucose Tolerance Test, Humans, Male, Middle Aged, Sleep Apnea Syndromes, Polysomnography, Glucose Intolerance, Cross-Over Studies, Continuous Positive Airway Pressure, Actigraphy

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