Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA. (14th May 2021)

• Record Type: Journal Article
• Authors: Tasbakan, Mehmet Sezai; Grote, Ludger; Hedner, Jan; Kvamme, John Arthur; Verbraecken, Johan; McNicholas, Walter T.; Roisman, Gabriel; Tkacova, Ruzena; Bonsignore, Maria R.; Saaresranta, Tarja; Steiropoulos, Paschalis; Marrone, Oreste; Basoglu, Ozen K.
• Other Names: Petiet Erna investigator.; Trakada Georgia investigator.; Fietze Ingo investigator.; Penzel Thomas investigator.; Laharnar Naima investigator.; Ludka Ondrej investigator.; Bouloukaki Izolde investigator.; Schiza Sophia investigator.; Ryan Silke investigator.; Riha Renata L. investigator.; Zou Ding investigator.; Bailly Sebastien investigator.; Pépin JeanLouis investigator.; Hein Holger investigator.; Buskova Jitka investigator.; Joppa Pavol investigator.; Staats Richard investigator.; Testelmans Dries investigator.; Gouveris Haralampos investigator.; Lombardi Carolina investigator.; Parati Gianfranco investigator.; Fanfulla Francesco investigator.; Petitjean Michel investigator.; Drummond Marta investigator.; Zeller Mafalda van investigator.; Herkenrath Simon investigator.; Randerath Winfried investigator.; Dogas Zoran investigator.; Galic Tea investigator.; Pataka Athanasia investigator.; Mihaicuta Stefan investigator.; Anttalainen Ulla investigator.; Sliwinski Pawel investigator.; Plywaczewski Robert investigator.;
• Is Part Of: Journal of sleep research. Volume 30:Number 5(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-05-14
• Subjects: HbA1c -- positive airway pressure therapy -- sleep apnea; Sleep -- Periodicals; Sleep disorders -- Periodicals; 612.821
• DOI: 10.1111/jsr.13331
• Languages: English
• ISSNs: 0962-1105

Abstract

Summary: Patients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes. The effects of positive airway pressure on glycemic control are contradictory. We therefore evaluated the change in glycated hemoglobin (HbA1c) in a large cohort of OSA patients after long‐term treatment with positive airway pressure. HbA1c levels were assessed in a subsample of the European Sleep Apnea Database [n=1608] at baseline and at long‐term follow up with positive airway pressure therapy (mean 378.9±423.0 days). In a regression analysis, treatment response was controlled for important confounders. Overall, HbA1c decreased from 5.98±1.01% to 5.93±0.98% (p=0.001). Patient subgroups with a more pronounced HbA1c response included patients with diabetes (−0.15±1.02, p=0.019), those with severe OSA baseline (−0.10±0.68, p=0.005), those with morbid obesity (−0.20±0.81, p<0.001). The strongest HbA1c reduction was observed in patients with a concomitant weight reduction >5 kilos (−0.38±0.99, p<0.001). In robust regression analysis, severe OSA (p=0.038) and morbid obesity (p=0.005) at baseline, and weight reduction >5 kilos (p<0.001) during follow up were independently associated with a reduction of HbA1c following PAP treatment. In contrast, PAP treatment alone without weight reduction was not associated with significant Hb1Ac reduction. In conclusion, positive airway pressure therapy is associated with HbA1c reduction in patients with severe OSA, in morbidly obese patients. and most obviously in those with significant weight lost during the follow‐up. Our study underlines the importance to combine positive airway pressure use with adjustments in lifestyle to substantially modify metabolic complications in OSA.