Using CPAP Can Stop the Progression of Metabolic Syndrome

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Using CPAP Can Stop the Progression of Metabolic Syndrome

By Admin

One of many studies presented online at the American Thoracic Society’s (ATS) 2020 International Conference shows a nearly five-fold increase in the probability of stopping or reversing the onset of metabolic syndrome with regular use of CPAP. Conducted by researchers at the University of Sao Paulo School of Medicine in Brazil, the study specifically tested whether CPAP would have an effect on various measures of metabolic illness, a common precursor to diabetes, stroke, and cardiovascular disease (CVD). Doctors and researchers have known for some time that a relationship exists between sleep apnea and metabolic health, but few studies have established a direct link. These findings show very clear correlations between using PAP therapy devices and a range of health benefits, further emphasizing the concern among doctors and sleep specialists that long-term adherence to CPAP therapy is critical for comprehensive health needs. Along with other improvements to heart health, memory, arteries, and sleep, metabolic health benefits give patients another reason to keep up with compliance to live a longer, healthier life.

What is Metabolic Syndrome?

Metabolic syndrome (MetS) is a combination of health factors contributing to the development of diabetes (usually type 2) or cardiovascular disease. Often closely associated with pre-diabetes, metabolic syndrome more specifically involves changes to body metabolism such as an increase in blood pressure, blood sugar, or cholesterol, while pre-diabetes is an intermediate condition between normoglycemia (normal glucose levels) and diabetes mellitus (elevated glucose with reduced insulin or insulin resistance). There are often crossover symptoms between these conditions, but. metabolic syndrome, as defined by the World Health Organization, must include three or more of the following: abdominal obesity (specifically around the waist), high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Each of these conditions is a metabolic change caused by body weight or inactivity. In the U.S., about a quarter of the adult population has metabolic health issues, and the prevalence increases with age. The most common indicator of metabolic changes is weight gain, especially around the midsection in what is known as central obesity or central adiposity. This condition can be very difficult to reverse, requiring long-term dietary and exercise regimens, as well as other lifestyle changes, to stop it from progressing. Insulin resistance, a common development of metabolic syndrome and a precursor to diabetes, occurs when cells throughout the body stop responding to the insulin hormone. According to CDC reports, over 30 percent of the U.S. population may have this condition, but it is often not recognized until other problems develop as a result. In fact, other than growth in waist circumference, most of the conditions associated with metabolic syndrome do not have obvious signs or symptoms, but when the syndrome develops further into diabetic or cardiovascular problems, a number of symptoms such as frequent urination, shortness of breath, blurred vision, or fatigue may follow. As with most health concerns, the best course of action for the prevention of metabolic syndrome is to have regular scheduled physical examinations and to adhere to any prescribed treatments from your primary health physician, including CPAP.

Metabolic Syndrome and Sleep Apnea

For those with sleep apnea, maintaining healthy metabolic functions is especially important for sleep health, respiratory health, and longevity. As noted in our previous article on morning arterial stiffness, a number of metabolic and cardiovascular processes can change during the sleeping hours, making patients susceptible to a host of negative health effects without regular adherence to proper treatment. Like metabolic syndrome, cardiovascular health depends on proper sleep, diet, physical activity, and weight ratio (BMI), and these effects become more consequential with age. Even without sleep apnea, these are important considerations for long-term health, but for a person diagnosed with OSA and possible comorbid conditions, metabolic syndrome may be the final pathway connecting sleep apnea with the development of diabetes, cardiovascular disease, or other comorbid conditions. While CPAP should not be the only treatment consideration when faced with multiple interrelated conditions, it is the gold standard for sleep apnea, and according to this study, a preventative measure for the development of metabolic problems commonly associated with OSA.

The Study

The Sao Paulo University study, titled “Effects of CPAP on Metabolic Syndrome in Patients with Obstructive Sleep Apnea: The TREATOSA-MS Randomized Controlled Trial,” used a placebo-controlled trial in which patients diagnosed with both metabolic syndrome and obstructive sleep apnea (OSA)—defined as an apnea-hypopnea index (AHI) of at least 15 events per hour) underwent either six months of regular CPAP use or a control therapy using nasal strips. The team then measured metabolic changes such as blood pressure, glucose levels, lipid profile, and weight changes, as well as any changes to body composition, daily activity, diet, or body fat. By the end of the study, CPAP was associated with significant improvements in sleep apnea severity as well as the metabolic factors. While some control patients (4 percent)) showed slight improvements in metabolic parameters after the six months, 18 percent of CPAP-treated patients reversed their metabolic syndrome significantly (OR, 5.27; 95% CI, 1.27-35.85; P = .04). While neither the control group nor the CPAP group reported significant changes in weight, food intake, physical activity, or body composition, this ensures that metabolic factors were isolated as effects of the treatment. Blood pressure, for example, showed the most significant changes among the treatment group (systolic BP -7±12mmHg vs -2±11mmHg; P = .03 and diastolic BP -5.8±mm Hg vs -1±8mmHg; P = .01). This change alone accounts for many of the improvements, as the drop in blood pressure allows the body to recover its normoglycemic functions. If left untreated, sleep apnea often leads to hypoxia (low blood-oxygen), which also affects blood pressure. As the CPAP machines help to stop apnea events in the night, the body is able to function normally during rest.

The Takeaway

These results, presented online for the American Thoracic Society’s 2020 International Conference, showed audiences a clear relationship between PAP therapy compliance and metabolic outcomes. While this link continues to be debated as researchers look further into the often complex interrelations between these common conditions, studies like these provide further evidence of the benefits of CPAP to overall health and quality of life. Metabolic syndrome affects the body in many ways and can very easily develop into more serious comorbid conditions, making it a high priority among healthcare providers, researchers, and the patients themselves. Along with healthy lifestyle choices and proper sleep hygiene, regular use of CPAP is clearly part of a larger, comprehensive approach to care and treatment, improving quality of life for years to come.