Research Highlights

Sleep Disordered Breathing (SDB) and type 2 diabetes

1. Independent Association

• SDB is independently associated with insulin resistance and DM2 1-3
• Insulin resistance correlated with increasing severity SDB 4, 5

2. Impact of CPAP therapy on glucose control

Preliminary studies indicate that effective treatment of OSA with n-CPAP in type 2 diabetic patients results in a statistically significant improvement in glycemic control that persists long-term (3-4 months) 6,7

Following 48 hours of CPAP therapy, patients with SDB showed significant improvements in insulin sensitivity, which was maintained long-term (3 months)
	Following CPAP therapy patients with OSA and type 2 diabetes showed a significant improvement in post-prandial glucoses that are maintained long-term.

3. Impact of CPAP therapy on hypertension

CPAP therapy in patients with OSA has been associated with a fall in mean arterial blood pressure of 10mmHg, a drop predictedto reduce coronary heart disease event risk by 37% and stroke risk by 56% 8

References

1 Punjabi NM, at al.. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004;160:521-530

2 Coughlin SR et al. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. European Heart J 2004;25:735-741.

3 Reichmuth K et al. Association of sleep apnea and type II diabetes: a population-based study. Am J Respir Crit Care Med 2005;172(12):1590-5

4 Ip MS, et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002;165:670-676.

5 Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP et al. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 2002; 165:677-682

6 Harsch I, Schahin S, et al. Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2004;169(2):156-62.

7 Babu AR, Herdegen J, Fogelfeld L, Shott S et al. Type 2 diabetes, glycemic control and continuous positive airway pressure in obstructive sleep apnea. Archives of Internal Medicine 2005; 165:447-452

8 Becker HF, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003, 107:68-73