OSA Predisposes People to Metabolic Defects, Study Finds

Obstructive sleep apnea (“OSA”) predisposes individuals to type 2 diabetes and hyperglycemia, despite research showing that positive airway pressure doesn’t boost glucose dysregulation markers. This sleep disorder has been linked to impaired glucose disposal. During a recent presentation, University of Miami Miller School of Medicine’s chief of division of pulmonary, sleep medicine and critical care Naresh M. Punjabi stated that obstructive sleep apnea also impaired insulin and was linked to changes in free fatty acid kinetics.

Punjabi explained that prior research had found that sleep apnea could speed up betacell compensation to insulin resistance, in addition to inducing insulin resistance. Different observational and cross-sectional studies that date back to the 1990s show that adults who snore or those with obstructive sleep apnea had a higher chance of having impaired glucose tolerance.

The Sleep Heart Health Study, which is one of the biggest longitudinal studies that evaluated cardiovascular disease and sleep apnea, was conducted in 2004. This study offered valuable data on glucose metabolism. Punjabi stated that the study provided insight into the dose-response relationship between sleep apnea severity and the prevalence of diabetic or impaired fasting glucose, adding that sleep apnea was also found to be linked to impaired fasting.

He went on to note that the most important finding was the degree of hypoxemia, which was also linked to fasting hyperglycemia. Hypoxemia refers to abnormally low oxygen concentration in the blood. Data also revealed that lower oxygen levels during sleep were linked to lower homeostatic model assessment, with some data also suggesting that obstructive sleep apnea was linked to impaired insulin secretion. Punjabi observed that the prevalence of type II diabetes, metabolic syndrome and metrics of insulin sensitivity were all linked to obstructive sleep apnea severity.

At the moment, there’s no adequate evidence from randomized controlled trials to suggest that Hemoglobin A1c or other glycemic response metrics improve treatment for obstructive sleep apnea. Hemoglobin A1c is a measure of how controlled an individual’s blood sugar has been over a period of time. It offers an idea of how average, low or high an individual’s blood glucose levels have been.

Punjabi adds that while using CPAP therapy to treat sleep apnea doesn’t improve glucose homeostasis, there exists observational data which demonstrates that after CPAP therapy, Hemoglobin A1c is lower. In addition, he asserts that while the data used is more than a decade old, it has been useful in helping prove that treating sleep apnea wouldn’t improve glycemic control.

Nevertheless, sleep apnea can lead to other complications, such as the likelihood of developing hypertension. Therefore, it may be prudent to treat it.

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