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Published on: December 7, 2017
Sleep-disordered breathing, glucose intolerance, and insulin resistance
Naresh M Punjabi1, Murtuza M Ahmed, Vsevolod Y Polotsky
1Division of Pulmonary and Critical Care Medicine, Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. npunjabi@jhmi.edu
Sleep-disordered breathing (SDB) is linked to glucose intolerance and insulin resistance, independent of obesity. While CPAP treatment shows inconsistent metabolic benefits, SDB remains a significant factor in impaired glucose homeostasis.
Area of Science:
- Cardiology
- Endocrinology
- Sleep Medicine
Background:
- Sleep-disordered breathing (SDB) affects 2-4% of the population and is an independent cardiovascular disease risk factor.
- Glucose intolerance and insulin resistance are established cardiovascular disease risk factors.
- Clinic-based studies suggest SDB may negatively impact glucose tolerance and insulin sensitivity, independent of obesity.
Purpose of the Study:
- To systematically review the evidence linking sleep-disordered breathing (SDB), glucose intolerance, and insulin resistance.
Main Methods:
- A comprehensive MEDLINE search was conducted for studies on SDB and metabolic disorders.
- Twenty-four relevant articles meeting inclusion criteria were identified and analyzed.
Main Results:
- Population-based studies show habitual snoring is independently associated with glucose intolerance and insulin resistance.
- Objective SDB measures (e.g., polysomnography) further support an independent link between SDB, glucose intolerance, and insulin resistance.
- Studies on continuous positive airway pressure (CPAP) treatment for SDB yielded inconsistent results regarding metabolic improvements.
Conclusions:
- Current evidence indicates an independent association between SDB and impaired glucose homeostasis.
- Potential mechanisms include altered adrenergic function, hypoxemia's effect on glucose regulation, and proinflammatory cytokine release.
- Further population-based prospective data are needed to fully understand the metabolic implications of SDB.
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