Claudio Liguori1, Francesca Izzi2, Nicola Biagio Mercuri3, Andrea Romigi4, Alberto Cordella5, Umberto Tarantino6, Fabio Placidi2. 1. Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. Electronic address: dott.claudioliguori@yahoo.it. 2. Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. 3. Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Fondazione Santa Lucia IRCCS, Rome, Italy. 4. Neurology Unit, San Giovanni Addolorata Hospital, Rome, Italy. 5. Fondazione Santa Lucia IRCCS, Rome, Italy. 6. Department of Orthopedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.
Abstract
OBJECTIVE: The aim of this study was to evaluate the effect of one-year useful continuous positive airway pressure (CPAP) treatment on serum vitamin D levels in middle-aged men affected by obstructive sleep apnea syndrome (OSAS). METHODS: This is a secondary investigation related to a previously published observational study about the effect of short-term CPAP therapy on serum vitamin D levels in severe OSAS (Apnea-Hypopnea Index - AHI- >30/h) patients. In the present study, we included patients participating to the previous investigation who repeated serum vitamin D assessment after one year of useful CPAP treatment, and compared to control a group of OSAS patients with scarce compliance to CPAP treatment. OSAS patients with beneficial use of CPAP treatment were distributed in obese (Body Mass Index - BMI ≥30) and non-obese (BMI < 30). Moreover, the mean change between baseline and one-year follow-up (Δ) of serum vitamin D levels was correlated with demographic, polygraphic and clinical data throughout a multiple regression analysis. RESULTS: We documented the significant increase of serum vitamin D levels after one year of CPAP treatment in the OSAS group (n = 39, p < 0.001) and in both subgroups of obese (n = 23, p < 0.01) and non-obese (n = 16, p < 0.01) OSAS patients. Conversely, OSAS patients with a scarce compliance to CPAP therapy did not change serum vitamin D levels after one year (n = 10, p > 0.05). OSAS patients with beneficial CPAP treatment showed higher vitamin D serum levels after one year and a more frequent shift from insufficient to sufficient vitamin D status compared to OSAS patients not adequately using CPAP treatment. In particular, the obese OSAS patients subgroup shifted from insufficient (≤20 ng/mL) to sufficient (>20 ng/mL) vitamin D status after CPAP therapy more than the non-obese OSAS patients subgroup (p < 0.05). We observed higher Δ of vitamin D serum levels, Epworth Sleepiness Scale score, and AHI in obese compared to non-obese OSAS patients. Finally, BMI obtained at baseline positively correlated with Δ of vitamin D serum levels. DISCUSSION: This study documented that long-term CPAP treatment is a viable therapeutic choice for correcting both sleep apnea condition and vitamin D deficiency in middle-aged male OSAS patients. Significantly, this effect was more evident in obese subjects and possibly represents a valid therapeutic strategy to ensure sufficient vitamin D levels in these patients, which frequently show a deficient vitamin D status.
OBJECTIVE: The aim of this study was to evaluate the effect of one-year useful continuous positive airway pressure (CPAP) treatment on serum vitamin D levels in middle-aged men affected by obstructive sleep apnea syndrome (OSAS). METHODS: This is a secondary investigation related to a previously published observational study about the effect of short-term CPAP therapy on serum vitamin D levels in severe OSAS (Apnea-Hypopnea Index - AHI- >30/h) patients. In the present study, we included patients participating to the previous investigation who repeated serum vitamin D assessment after one year of useful CPAP treatment, and compared to control a group of OSAS patients with scarce compliance to CPAP treatment. OSAS patients with beneficial use of CPAP treatment were distributed in obese (Body Mass Index - BMI ≥30) and non-obese (BMI < 30). Moreover, the mean change between baseline and one-year follow-up (Δ) of serum vitamin D levels was correlated with demographic, polygraphic and clinical data throughout a multiple regression analysis. RESULTS: We documented the significant increase of serum vitamin D levels after one year of CPAP treatment in the OSAS group (n = 39, p < 0.001) and in both subgroups of obese (n = 23, p < 0.01) and non-obese (n = 16, p < 0.01) OSAS patients. Conversely, OSAS patients with a scarce compliance to CPAP therapy did not change serum vitamin D levels after one year (n = 10, p > 0.05). OSAS patients with beneficial CPAP treatment showed higher vitamin D serum levels after one year and a more frequent shift from insufficient to sufficient vitamin D status compared to OSAS patients not adequately using CPAP treatment. In particular, the obese OSASpatients subgroup shifted from insufficient (≤20 ng/mL) to sufficient (>20 ng/mL) vitamin D status after CPAP therapy more than the non-obese OSASpatients subgroup (p < 0.05). We observed higher Δ of vitamin D serum levels, Epworth Sleepiness Scale score, and AHI in obese compared to non-obese OSASpatients. Finally, BMI obtained at baseline positively correlated with Δ of vitamin D serum levels. DISCUSSION: This study documented that long-term CPAP treatment is a viable therapeutic choice for correcting both sleep apnea condition and vitamin D deficiency in middle-aged male OSAS patients. Significantly, this effect was more evident in obese subjects and possibly represents a valid therapeutic strategy to ensure sufficient vitamin D levels in these patients, which frequently show a deficient vitamin D status.
Authors: Alberto Herrero Babiloni; Beatrice P De Koninck; Gabrielle Beetz; Louis De Beaumont; Marc O Martel; Gilles J Lavigne Journal: J Neural Transm (Vienna) Date: 2019-08-26 Impact factor: 3.575
Authors: Ronaldo D Piovezan; Camila Hirotsu; Marcia C Feres; Fatima D Cintra; Monica L Andersen; Sergio Tufik; Dalva Poyares Journal: PLoS One Date: 2017-07-07 Impact factor: 3.240