Effects of 8 weeks of continuous positive airway pressure on abdominal adiposity in obstructive sleep apnoea

Abstract

The aim of the present study was to investigate the effect of continuous positive airway pressure (CPAP) treatment on regional adipose tissue distribution in patients with moderate or severe obstructive sleep apnoea.Patients received both therapeutic and sham CPAP in a random order for 2 months each with an intervening 1-month washout. Abdominal subcutaneous, visceral and liver fat were quantified using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). Liver enzymes and plasma glucose were also determined. Measurements were obtained at baseline and at the end of both treatment arms.38 eligible patients were randomly assigned to a treatment order, with 27 patients having complete MRI/MRS data. No significant difference was observed in subcutaneous (-28.6 cm ; p50.33), remained unchanged. In this first randomised, sham-controlled trial, there was no change in adipose tissue distribution after 8 weeks of therapeutic CPAP compared with 8 weeks of sham CPAP. Longer duration of CPAP use may be necessary to demonstrate a difference.

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

“…In a recent randomized controlled trial, 24 weeks of CPAP treatment alone (on average z4 h per night) did not improve insulin sensitivity as assessed by ivGTT (27). Previous randomized controlled trials have found no benefit of CPAP treatment on measures of glucose metabolism when the duration of average CPAP use ranged from 3.3 to 6.2 hours per night (20)(21)(22)(23)(24)(25)(26)(27)(28). In one controlled study involving individuals with prediabetes, 2 months of CPAP use (on average z4.8 h per night) led to an improvement in insulin sensitivity only in those who had severe OSA (29).…”

“…Despite this strong association between OSA and alterations in glucose metabolism, there is still controversy as to whether treatment of OSA with continuous positive airway pressure (CPAP) has metabolic benefits (18,19). Prior randomized controlled trials investigating the effects of CPAP on measures of glucose metabolism yielded mostly negative results (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The average duration of CPAP use in these trials ranged from 3.3 to 6.2 hours per night.…”

You Still Need More than CPAP for OSA Patients to Lose Weight

“…6 Most, but not all studies report that visceral fat does not decrease with CPAP use. 4,5,[7][8][9] Moreover, in the study by Muntzer et al, 4 there was a trend for an increase in visceral fat with CPAP, although it did not reach statistical signifi cance. However, waist circumference 4 and subcutaneous fat 5 increased.…”

Liver enzymes in obstructive sleep apnoea syndrome

“…Our findings are in agreement with the only randomized placebo controlled study by Kohler et al [38] who did not find any effect of therapeutic CPAP treatment for 4 weeks on liver enzymes compared to sham CPAP. Sivam et al [39] in a randomized double-blinded sham controlled trial of CPAP for 8 weeks reported no effect of CPAP on liver enzyme. In contrast to [40] demonstrated abnormal serum aminotransferase levels in 35% of obese OSAS patients included in the study.…”