Abstract
Obstructive sleep apnoea is a highly prevalent chronic disorder and has been shown to be associated with disturbed glucose metabolism and type 2 diabetes. However, the evidence from individual clinical trials on the effect of continuous positive airway pressure (CPAP) treatment on glycaemic control in patients with co-existing obstructive sleep apnoea and type 2 diabetes remains controversial. A systematic review of randomised controlled trials assessing the effect of CPAP on glycaemic control in patients with obstructive sleep apnoea and type 2 diabetes was conducted using the databases MEDLINE, Embase, Cochrane and Scopus up to December 2022. Meta-analysis using a random-effect model was performed for outcomes that were reported in at least two randomised controlled trials. From 3031 records screened, 11 RCTs with a total of 964 patients were included for analysis. CPAP treatment led to a significant reduction in haemoglobin A1c (HbA1c) (mean difference −0.24%, 95% CI −0.43– −0.06%, p=0.001) compared to inactive control groups. Meta-regression showed a significant association between reduction in HbA1c and hours of nightly CPAP usage. CPAP therapy seems to significantly improve HbA1c and thus long-term glycaemic control in patients with type 2 diabetes and obstructive sleep apnoea. The amount of improvement is dependent on the hours of usage of CPAP and thus optimal adherence to CPAP should be a primary goal in these patients.
Tweetable abstract
CPAP therapy seems to significantly improve HbA1c in patients with type 2 diabetes and OSA. The amount of improvement is associated with the hours of usage of CPAP; optimal adherence to CPAP should be a primary goal in these patients. https://bit.ly/3CZL9ic
Footnotes
Provenance: Submitted article, peer reviewed.
Author contributions: J. Herth and M. Kohler developed the idea of the study. Data acquisition was done by J. Herth, F. Schmidt and N.A. Sievi. Statistical analysis was performed by J. Herth and N.A. Sievi. The manuscript was drafted by J. Herth, who had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. M. Kohler and F. Schmidt guaranteed administrative and technical material support. The study was supervised by M. Kohler. All authors contributed to the final manuscript and checked the final manuscript for correctness.
Data sharing: All data were extracted from published sources that are publicly available or were requested from individual trials. Relevant meta-level data and analytical code on which this analysis is based are available on request to the corresponding author (M. Kohler).
Conflict of Interest: M. Kohler reports consulting fees from Bayer, Novartis, GSK, Boehringer Ingelheim, Mundipharma and Astra. All other authors have nothing to disclose.
- Received April 24, 2023.
- Accepted June 27, 2023.
- Copyright ©The authors 2023
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