Gonzalo Labarca1,2,3, Tomas Reyes4, Jorge Jorquera3,5, Jorge Dreyse3,5, Lauren Drake6. 1. Facultad de Medicina, Universidad San Sebastian, Concepcion, Chile. 2. Medicina Interna, Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Chile. 3. Evidence Based Medicine in Pulmonology (EBMIP) Working Group, Concepcion, Chile. 4. Medicina Interna, Pontificia Universidad Catolica de Chile, Santiago, Chile. 5. Centro de Enfermedades respiratorias, Clinca Las Condes, Santiago, Chile. 6. Medical Student, A.T. Still University Kirksville College of Osteopathic Medicine, Kirksville, MO.
Abstract
INTRODUCTION: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent condition across the world; it co-exists with others metabolic diseases, such as central obesity, dyslipidemia, and arterial hypertension. These associations increase the cardiovascular risk and mortality. Observational studies have reported a strength association between OSA and type 2 Diabetes Mellitus (T2DM) and continuous positive airway pressure (CPAP) is recommended for moderate to severe OSAHS. OBJECTIVE: To summarize the evidence of CPAP in T2DM patients with OSAHS. METHODS: A compressive search in Medline, Cochrane, Ovids, Epistemonikos, and DARE was performed. Two reviewers evaluated included studies, extracted data, carried out quality assessment and summarized the result. Pooled data was evaluated by meta-analysis and summaries of results and evidence grading were performed through the GRADE method. RESULTS: Six randomized controlled trials (RCTs), including a total of 581 participants. Treatment with CPAP showed no effectiveness regarding changing glycated hemoglobin (HbA1c) levels at 12 or 24 weeks after treatment; (Mean difference= -0.10; Confidence interval -0.25 to 0.04) (GRADE: MODERATE). Subgroup analysis by adherence to CPAP (> 4 hours or < 4 hours) confirmed these results. Other indirect outcomes, such as change in fasting glucose levels, were similar in CPAP population and placebo. DISCUSSION: This systematic review and meta-analysis evaluates the evidence regarding the efficacy of CPAP in patients with T2DM and OSAHS. In conclusion, CPAP does not improve glycemic control measure as HbA1c.
INTRODUCTION: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent condition across the world; it co-exists with others metabolic diseases, such as central obesity, dyslipidemia, and arterial hypertension. These associations increase the cardiovascular risk and mortality. Observational studies have reported a strength association between OSA and type 2 Diabetes Mellitus (T2DM) and continuous positive airway pressure (CPAP) is recommended for moderate to severe OSAHS. OBJECTIVE: To summarize the evidence of CPAP in T2DM patients with OSAHS. METHODS: A compressive search in Medline, Cochrane, Ovids, Epistemonikos, and DARE was performed. Two reviewers evaluated included studies, extracted data, carried out quality assessment and summarized the result. Pooled data was evaluated by meta-analysis and summaries of results and evidence grading were performed through the GRADE method. RESULTS: Six randomized controlled trials (RCTs), including a total of 581 participants. Treatment with CPAP showed no effectiveness regarding changing glycated hemoglobin (HbA1c) levels at 12 or 24 weeks after treatment; (Mean difference= -0.10; Confidence interval -0.25 to 0.04) (GRADE: MODERATE). Subgroup analysis by adherence to CPAP (> 4 hours or < 4 hours) confirmed these results. Other indirect outcomes, such as change in fasting glucose levels, were similar in CPAP population and placebo. DISCUSSION: This systematic review and meta-analysis evaluates the evidence regarding the efficacy of CPAP in patients with T2DM and OSAHS. In conclusion, CPAP does not improve glycemic control measure as HbA1c.
Authors: Cem Tanriover; Duygu Ucku; Merve Akyol; Enes Cevik; Asiye Kanbay; Vikas S Sridhar; David Z I Cherney; Mehmet Kanbay Journal: Sleep Breath Date: 2022-04-04 Impact factor: 2.816
Authors: Julia A M Uniken Venema; Grietje E Knol-de Vries; Harry van Goor; Johanna Westra; Aarnoud Hoekema; Peter J Wijkstra Journal: J Clin Sleep Med Date: 2022-06-01 Impact factor: 4.324
Authors: Jakub Mochol; Jakub Gawrys; Damian Gajecki; Ewa Szahidewicz-Krupska; Helena Martynowicz; Adrian Doroszko Journal: Int J Mol Sci Date: 2021-05-12 Impact factor: 5.923
Authors: Christopher Gerdung; Sara Rodriguez-Lopez; Stefan Palkowski; Diana Keto-Lambert; Meghan Sebastianski; Maria Luisa Castro Codesal Journal: BMJ Open Date: 2020-08-23 Impact factor: 2.692