Effect of long-term CPAR therapy on metabolic profile of patients with mild obstructive sleep apnea

DOI: https://dx.doi.org/10.18565/pharmateca.2021.5.81-86

M.V. Gorbunova (1), S.L. Babak (1), V.S. Borovitsky (2), A.G. Malyavin (1)

1) A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; 2) Kirov State Medical University, Kirov, Russia
Background. Continuous Positive Airway Pressure (CPAP) therapy is a fundamental therapeutic doctrine for patients with obstructive sleep apnea (OSA). The effects of long-term CPAP therapy significantly depend on comorbid conditions and are poorly predictable and understood, especially in the case of mild OSA patients.
Objective: to study the effect of 12-month CPAP therapy on the metabolic profile mild OSA patients.
Methods. In a one-year cohort study we included 102 patients (100 men [98%]), with a median age of 44 years (40,3–50,0), who had a verified mild OSA (apnea-hypopnea index (AHI) from 5/h up to 15/h) and metabolic disorders, who signed an informed consent to participate. All patients with OSA were on selected antihypertensive and lipid-lowering therapy. The nature and severity of sleep apnea was verified by performing computer somnography (CSG) on the WatchPAT-200 hardware complex (ItamarMedical, Israel) with the original software PATTMSW ver. (ItamarMedical, Israel) by registering the main respiratory polygraphic characteristics in the period 11:00 PM – 7:30 AM. The patient’s metabolic status was compiled according to the results of the assessment of lipid, carbohydrate, hormonal profiles based on standardized laboratory data on 0 – 3 – 6 – 12 months of observation. All patients underwent targeted ambulatory CPAP therapy to achieve optimal correction of sleep apnea with AHI <5/h.
Results. The effects of long-term CPAP therapy occurring at 12 months are associated with a decrease in ESS, with a decrease in visceral adiposity index, with a decrease in insulin resistance, a decrease in the level of LDL, a decrease in the Apo-B index, as well as an increase in testosterone levels with a decrease in leptin levels.
Conclusions. The positive effects of CPAP therapy on the “metabolic profile” of patients with mild OSA are associated with the elimination of sleep fragmentation and nocturnal hypoxemia when performed for more than 12 months.

About the Autors

Corresponding author: Sergey L. Babak, Dr. Sci. (Med.), Professor of the Department of Phthisiology and Pulmonology, Faculty of Medicine, 
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; sergbabak@mail.ru
Address: build. 1, 20 Delegatskaya St., Moscow 127473, Russian Federation

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