Table 3.
Studies examining the effects of continuous positive airway pressure (CPAP) treatment on measures of glucose metabolism in patients with obstructive sleep apnea (OSA)
| Author/Year | Sample | Average BMI (kg/m2) | Measures of Glucose Metabolism | Treatment duration | Average CPAP adherence (h/night) | Main findings |
|---|---|---|---|---|---|---|
| Positive studies | ||||||
| Harsch et al.[61] (2004) | 40 (34 men) | ∼ 33 | Hyperinsulinemic euglycemic clamp | 3 months | ∼5.2 | Insulin sensitivity improved after 2 days and remained stable after 3 months |
| Lindberg et al.[60] (2006) | 28 men | ∼ 29 | HOMA, fasting insulin | 6 months | ∼5.2 | Improvement in insulin sensitivity and fasting insulin after 2 weeks of CPAP |
| Barcelo et al.[59] (2008) | 44 men | ∼ 29 | HOMA | 3 months | ∼5.6 | Improvement in insulin sensitivity only in patients with daytime sleepiness (n=22) |
| Dorkova et al.[58] (2008) | 32 (27 men) | ∼ 35 | HOMA | 8 weeks | Not reported | Improvement in insulin sensitivity in those who used CPAP ≥ 4 h/night (n=16) |
| Schahin et al.[57] (2008) | 9 patients | ∼ 34 | Hyperinsulinemic euglycemic clamp | 2.9 years | ∼5.2 | Improvement in insulin sensitivity |
| Cuhadaroglu et al.[56] (2009) | 31 (27 men) | ∼ 32 | HOMA | 8 weeks | Not reported | Improvement in insulin sensitivity |
| Henley et al.[55] (2009) | 15 men | ∼ 36 | HOMA, OGTT | 3 months | ∼5.3 | Improvement in insulin sensitivity Reduced fasting and post-load glucose |
| Steiroploulos et al.[54](2009) | 56 (50 men) | ∼ 36 | HbA1c, fasting glucose, HOMA | 6 months | ∼2.7 | Decrease in HbA1c in those who used CPAP ≥ 4 h/night (n=21) |
| Lam et al.[53] (2010) | 61 men | ∼ 28 | Short Insulin Tolerance Test | 3 months | ∼ 4.9 | Improvement in insulin sensitivity in those who received therapeutic CPAP (n=31) |
| Negative studies | ||||||
| Saini et al.[63] (1993) | 8 men | ∼ 33 | Profiles of glucose and insulin at night | 1 night | Not reported | No change in nocturnal glucose and insulin |
| Cooper et al.[62] (1995) | 6 men | ∼ 38 | Profiles of glucose and insulin at night | 1 night | Not reported | No change in nocturnal glucose and insulin |
| Stoohs et al.[68] (1996) | 5 patients | Not reported | Fasting glucose and insulin | 2 months | Not reported | Increase in fasting and nocturnal glucose No change in fasting and nocturnal insulin |
| Saarlainen et al.[67] (1997) | 7 (6 men) | ∼ 34 | Hyperinsulinemic euglycemic clamp | 3 months | ∼5.6 | No change in insulin sensitivity |
| Ip et al.[66] (2000) | 9 patients | Not reported | Fasting glucose and insulin | 6 months | Not reported | No change in fasting glucose and insulin |
| Smurra et al.[65] (2001) | 16 men | ∼30 | Hyperinsulinemic euglycemic clamp, OGTT | 2 months | ∼ 6.4 | No change in insulin sensitivity and glucose tolerance |
| Czupryniak et al.[64] (2005) | 9 patients | ∼35 | HOMA, continuous glucose monitoring, fasting insulin | 1 night | Not reported | Increased nocturnal glucose No change in insulin resistance |
| Trenell et al.[73] (2007) | 29 patients | ∼35 | HOMA | 3 months | ∼6 (n=19) ∼2 (n=10) | No change in insulin sensitivity |
| Coughlin et al.[72] (2007) | 34 men | ∼36 | Fasting glucose and insulin, HOMA | 6 weeks | ∼3.9 | No change in glucose and insulin sensitivity with CPAP compared to sham CPAP |
| Vgontzas et al.[71] (2008) | 16 men | ∼38 | Fasting glucose and insulin | 3 months | ∼4.6 | No change in fasting glucose and insulin |
| Carneiro et al.[70] (2009) | 7 men | ≥ 40 | HOMA | 3 months | ∼6.6 | No change in insulin sensitivity |
| Murri et al.[69] (2009) | 78 (67 men) | ∼32 | HOMA | 4 weeks | Not reported | No change in insulin sensitivity |
HOMA=Homeostatic model assessment; HbA1c: Hemoglobin A1c; OGTT: Oral glucose tolerance test