Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA

Taşbakan, Mehmet Sezai; Grote, Ludger; Hedner, Jan; Kvamme, John Arthur; Verbraecken, Johan; McNicholas, Walter T.; Roisman, Gabriel; Tkáčová, Ružena; Bonsignore, Maria R.; Saaresranta, Tarja; Steiropoulos, Paschalis; Marrone, Oreste; Başoğlu, Özen K.

doi:10.1111/jsr.13331

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…This argument may also involve non-obese individuals; nonetheless, this was not a subject of investigation in the present study. Accordingly, Tasbakan et al provided evidence for a dose-response relationship between OSA treatment during long-term positive airway pressure (PAP) therapy and improved glycemic control in morbidly obese patients [23]. In their study, HbA1c was significantly reduced by PAP therapy, so the authors stressed the importance of PAP therapy to substantially modify diabetic complications in OSA patients.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals

et al. 2022

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The link between obstructive sleep apnea (OSA) and obesity, and their common comorbidities such as diabetes mellitus (DM) or cardiovascular diseases, is not fully understood. The aim of this study was to investigate the possible association of OSA severity in obese individuals with polysomnography-based sleep parameters, as well as C-reactive protein (CRP) and glycated hemoglobin (HbA1c) serum levels. Polysomnographic recordings and blood samples were retrospectively compared between a group of 23 adult obese individuals with mild OSA (apnea–hypopnea index (AHI) = 7.5 (5.5–12.5)/h, age = 42.57 ± 11.44 years, 16 male, 7 female, body mass index (BMI) = 37.35 ± 3.88 kg/m²) and an age-, sex-, and BMI-matched group of individuals with moderate or severe OSA (AHI 41.5 (25.7–71.8)/h, age = 43.43 ± 11.96 years, 16 male, 7 female, BMI = 37.87 ± 4.74 kg/m²). All respiratory sleep-associated parameters were significantly higher in individuals with moderate and severe OSA compared to those with mild OSA. CRP levels did not differ between the two OSA severity groups. However, serum levels of HbA1c were significantly higher in the moderate/severe OSA group. Therefore, OSA severity may have a significant impact on glycemic control in obese individuals. Additionally, OSA severity did not appear to be further associated with systemic inflammation in obese individuals. Obese individuals may benefit not only from lifestyle modification, but also from OSA screening and treatment, particularly to prevent DM-associated disorders and conditions.

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Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals

et al. 2022

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“…This leads to performance degradation and affects the patient's cognitive performance and quality of life [3,4]. The cumulative effect of this nocturnal oxygen deprivation has a proven negative impact on the patient's cardiovascular health and causes many other co-morbidities and OSA-related mortality [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Hypoglossal Nerve Stimulation Therapy in a Belgian Cohort of Obstructive Sleep Apnea Patients

Van Loo,

Dieltjens,

Engelen

et al. 2024

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Hypoglossal nerve stimulation (HGNS) has emerged as a widespread and innovative treatment option for selected moderate-to-severe obstructive sleep apnea (OSA) patients who cannot be treated effectively with traditional treatment modalities. In this observational cohort study, the objective and subjective outcomes of Belgian OSA patients treated with HGNS therapy were analyzed at 6 and 12 months post-implantation. Thirty-nine patients implanted with a respiration-synchronized HGNS device at the Antwerp University Hospital w ere included in this study. Patients underwent baseline in-laboratory polysomnography and a follow-up sleep study 6 and 12 months post-implantation. Questionnaires on patient experience and daytime sleepiness were filled out and data on objective therapy usage were collected. All 39 patients completed the 6-month follow-up and 21 patients (54%) completed the 12-month follow-up. Median AHI decreased from 33.8 [26.1;45.0] to 10.2 [4.8;16.4] at the 6-month follow-up, and to 9.6 [4.1;16.4] at the 12-month follow-up (p < 0.001). The surgical success rate, according to the Sher20 criteria, was 80% and 76% at the 6- and 12-month follow-ups, respectively. Median ESS improved from 12.0 [7.0;18.0] at baseline to 6.0 [2.5;11.0] at 6 months (p < 0.001) and to 6.5 [2.8;11.5] at 12 months (p = 0.012). Objective therapy usage was 7.4 [6.6;8.0] and 7.0 [5.9:8.2] h/night at the 6- and 12-month follow-ups, respectively. A high overall clinical effectiveness of HGNS therapy, as shown by a mean disease alleviation of 58%, was demonstrated at 12 months post-implantation. Overall, HGNS therapy using respiration-synchronized neurostimulation of the XII cranial nerve resulted in a significant improvement in both objective and subjective OSA outcomes, with a high level of patient satisfaction and high treatment adherence.

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“…A longitudinal study in 1272 non‐diabetic and 336 diabetic subjects analysed the changes in HbA1c levels after long‐term CPAP treatment (Tasbakan et al., 2021). OSA alleviation was calculated as changes in AHI.…”

Section: Introductionmentioning

confidence: 99%

“…OSA alleviation was calculated as changes in AHI. Overall HbA1c changed little after OSA treatment, but larger decreases in HbA1c were seen in patients with morbid obesity or type 2 diabetes, and in patients who lost weight (>5 kg) (Tasbakan et al., 2021). These results underline the complexity of glycaemic control in OSA, and the role of obesity as a frequent confounder, accounting for the uncertainties reported by different reports on this topic.…”

Section: Introductionmentioning

confidence: 99%

Adaptive responses to chronic intermittent hypoxia: contributions from the European Sleep Apnoea Database (ESADA) Cohort

Bonsignore

2023

The Journal of Physiology

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Obstructive sleep apnoea (OSA) is a common disease in the general population, and is associated with increased cardiovascular risk and several comorbidities. Obesity favours upper airway collapsibility, but other pathophysiological traits have been identified, i.e. upper airway muscle activity, modulation of the respiratory drive, and the arousal threshold. OSA causes chronic intermittent hypoxia, inflammatory activation and autonomic imbalance with diurnal and nocturnal sympathetic hyperactivity. Disentangling so many components to investigate the pathogenesis of OSA's consequences is very hard clinically. However, albeit imperfect, clinical medicine constitutes a major source of inspiration for basic research, and a mutual exchange of information is essential between clinicians and physiologists to improve our understanding of disease states. OSA is no exception, and this narrative review will summarize the results of clinical studies performed over the years by the European Sleep Apnoea Database (ESADA) Study Group, to explore the variables linked to markers of intermittent hypoxia as opposed to the traditional assessment of OSA severity based on the frequency of respiratory events during sleep (the Apnoea Hypopnoea Index). The results of the clinical studies indicate that intermittent hypoxia variables are associated with several comorbidities, although evidence of a cause–effect relationship is still missing in many cases. It is also possible that adaptive rather than maladaptive responses could be evoked by intermittent hypoxia. The intensity, duration and frequency of intermittent hypoxia episodes causing adaptive rather than maladaptive responses, and their clinical implications, deserve further investigation. image

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Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA

Cited by 7 publications

References 26 publications

Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals

Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals

Hypoglossal Nerve Stimulation Therapy in a Belgian Cohort of Obstructive Sleep Apnea Patients

Adaptive responses to chronic intermittent hypoxia: contributions from the European Sleep Apnoea Database (ESADA) Cohort

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