title: The Relationship between Metformin and Obstructive Sleep Apnea.
abstract: OBJECTIVE
  This study aimed to assess if metformin had any associations with the prevalence of obstructive sleep apnea in an adult type 2 diabetes population in the Midwest.
  
  
  OBJECTIVE
  Use of metformin is associated with decreased prevalence of obstructive sleep apnea in a adult type 2 diabetes population.
  
  
  METHODS
  A retrospective secondary database analysis was carried out with metformin use by patients with type 2 diabetes as the primary variable of interest and obstructive sleep apnea status as the primary outcome. A sample population of 9,853 type 2 diabetes patients with one year of follow-up was used. Other variables that were analyzed included age, gender, race, hypertension, Congestive Heart Failure, Hemoglobin A1c (HbA1c), and Body Mass Index. A p-value of <0.01 was considered significant.
  
  
  RESULTS
  Metformin usage was not significantly associated with obstructive sleep apnea prevalence (Odds Ratio: 1.17, Confidence Interval: 1.00-1.36, p = 0.049), but trended in the direction where metformin usage was associated with having obstructive sleep apnea. Lower HbA1c was found to be significantly associated with lower prevalence of obstructive sleep apnea (p <0.001). The rest of the variables followed previously published associations.
  
  
  CONCLUSIONS
  Metformin therapy may improve sleep quality, but it may not be through methods that reduce the likelihood of developing obstructive sleep apnea. Future studies that can prove causation about this association should be considered.
authors.affiliation: Clinical and Translational Science Institute, Medical College of Wisconsin (MCW), USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lin
authors.affiliation: Division of Biostatistics, Institute for Health and Society, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rein
authors.affiliation: Division of Biostatistics, Institute for Health and Society, USA.
authors.forename: Sergey
authors.initials: S
authors.lastname: Tarima
authors.affiliation: Department of Otolaryngology, MCW, USA.
authors.forename: B Tucker
authors.initials: BT
authors.lastname: Woodson
authors.affiliation: Division of Population Health Improvement, Institute for Health and Society, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Meurer
keywords: Insulin resistance; Metformin; Obstructive sleep apnea; Type 2 diabetes