CPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure

Nov 7, 2016Sleep & breathing = Schlaf & Atmung

CPAP treatment for sleep apnea and type 2 diabetes helps lower blood pressure

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Abstract

Sixty-four patients with obstructive sleep apnea and type 2 diabetes were studied for 3 months.

No significant change in HbA1c levels was observed in the CPAP treatment group compared to the control group.
CPAP treatment resulted in a significant reduction in systolic blood pressure by 10 mmHg and diastolic blood pressure by 6 mmHg.
In a subgroup analysis excluding those with medication changes or dietary programs, CPAP treatment decreased HbA1c by 0.4%.
These findings suggest that while CPAP may lower blood pressure, its effect on glycemic control could be limited.
Future studies should account for external factors such as medications and dietary changes when assessing CPAP's impact.

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PURPOSE: Obstructive sleep apnea (OSA) is highly associated with type 2 diabetes mellitus (DM), and treatment of OSA may have a positive impact on cardiometabolic profile. This study investigates the effects of continuous positive airway pressure (CPAP) treatment on glycemic control and cardiometabolic parameters in patients with diabetes.

METHODS: Diabetic patients, who were newly diagnosed of OSA with an apnea hypopnea index (AHI) ≥15 and HbA1c ≥7%, were randomly assigned to either CPAP treatment or no treatment (control) for 3 months. Measurements included HbA1c, blood pressure, fasting glucose and lipids, urinary albumin, and peripheral arterial tonometry (to assess endothelial function).

RESULTS: Sixty-four patients (52 men) were randomized, with mean (±SD) age of 55.0 ± 9.6 years, body mass index of 29.9 ± 5.3 kg/m, HbA1c of 8.1 ± 1.1%, and AHI of 45.3 ± 23.2 events/h. In the intention-to-treat analysis, no significant change in HbA1c but reduction of systolic (10 mmHg (-18 to -2), p < 0.05) and diastolic (6 mmHg (-11 to -1), p < 0.05) blood pressures were found in the CPAP group compared to the control group. Excluding those with medication changes or initiated dietary program during the study period and those who dropped out, CPAP treatment decreased HbA1c (intervention group, n = 27; control group, n = 26) by 0.4% (-0.7 to -0.1), p = 0.027. 2

CONCLUSIONS: In patients with type 2 DM and moderate to severe OSA, 3 months of CPAP therapy did not decrease HbA1c but lowered systolic and diastolic blood pressures. In view of a potentially limited effect size of CPAP treatment on glycemic control, sample size estimation for future randomized controlled studies must make adequate allowance for influence from external factors of medications/diet and CPAP use.

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CPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure

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