title: The effect of continuous positive airway pressure on metabolic variables in patients with obstructive sleep apnoea.
abstract: Obstructive sleep apnoea (OSA) is increasingly considered as a risk factor for metabolic disturbances, such as diabetes mellitus or dyslipidaemia. Continuous positive airway pressure (CPAP) therapy, the standard treatment for patients with OSA, may improve various metabolic variables, such as insulin sensitivity, glucose metabolism, lipids, fat distribution and adipokines. Several observational and uncontrolled clinical studies claim an improvement of these metabolic variables through the use of CPAP. However, there is only a limited number of clinical randomised controlled trials (RCTs) evaluating the effect of CPAP on metabolic variables. In this review, we summarise and discuss non-randomised studies and RCTs evaluating the effect of CPAP on metabolic variables in patients with OSA. In summary, the currently available body of evidence does not support a clinically important effect of CPAP treatment on any of the investigated metabolic variables. However, some investigators found small, but statistically significant changes in some metabolic variables, thus beneficial effects of CPAP treatment in selected patient cohorts cannot be excluded. To answer this question, more data from RCTs with well-defined study populations are warranted.
authors.affiliation: 1Sleep Disorders Centre and Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schlatzer
authors.forename: Esther I
authors.initials: EI
authors.lastname: Schwarz
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
mesh_terms: D054392:Adipokines / Q000378:metabolism; D050218:Body Fat Distribution; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D050356:Lipid Metabolism / Q000502:physiology*; D008659:Metabolic Diseases / Q000209:etiology / Q000378:metabolism; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism / Q000628:therapy
chemical_list: D054392:Adipokines; D005947:Glucose
keywords: Obstructive sleep apnoea (OSA); adipokines; continuous positive airway pressure (CPAP); diabetes mellitus; fat distribution; lipids; metabolic syndrome