Sleep apnea treatment is tied to reduced T2D risk

  • Xu PH & al.
  • Chest
  • 22 May 2019

  • International Clinical Digest
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Takeaway

  • Obstructive sleep apnea (OSA) is an independent risk factor for type 2 diabetes (T2D).  
  • Long-term treatment of moderate-severe OSA with continuous positive airway pressure (CPAP) may reduce T2D risk.
  • CPAP adherence should be encouraged.

Why this matters

  • The relationship between OSA and glucose metabolism is controversial.

Study design

  • Analysis of data for 1206 Hong Kong sleep clinic patients without baseline diabetes who underwent full-night polysomnography in 2006-2013.
  • Funding: Ho Ting Sik Donation Fund for Sleep Research.

Key results

  • With median follow-up of 88.1 months, 12.6% developed incident T2D, for an incidence rate of 1.83 (95% CI, 1.56-2.14)/100 person-years.
  • T2D incidence rose with OSA severity (Ptrend<.005>
  • Partially adjusted HR for untreated mild OSA was not significantly different from those without OSA (1.37; 95% CI, 0.70-2.66), whereas HRs for untreated moderate and severe OSA patients were significantly higher (2.16; 1.14-4.08 and 2.94; 1.59-5.43, respectively).
  • Apnea-hypopnea index (as continuous variable) was independently associated with increased T2D risk (1.01; P=.001).
  • For the 624 with moderate/severe OSA, adjusted HR in the CPAP-treated group was lower (1.35; 95% CI, 0.69-2.67) than untreated group (2.51; 1.41-4.46) and similar to the risk for those without OSA (ref).  

Limitations

  • Observational, retrospective study.
  • Participants were all Asian.