CPAP Treatment May Prevent Progression to Diabetes

Continuous positive airway pressure is a mainstay of treatment for obstructive sleep apnea.
Continuous positive airway pressure is a mainstay of treatment for obstructive sleep apnea.
Sleep apnea treatment may improve glucose control and blood pressure and prevent progression to diabetes in patients with prediabetes.

Eight hours per night of continuous positive airway pressure (CPAP) therapy, used to treat sleep apnea, may improve blood glucose control and decrease the risk for developing full-blown diabetes in patients with prediabetes, new data published in the American Journal of Respiratory and Critical Care Medicine indicate.

“Our study showed that CPAP in patients with prediabetes can lower their risk of progressing to diabetes when CPAP is used for 8 hours, a full night’s sleep,” lead study author Sushmita Pamidi, MD, a former fellow at the University of Chicago who is now on the faculty at McGill University in Montreal, Canada, said in a press release.

“Although 8 hours of CPAP per night can be difficult to achieve in real life, our results should provide a strong incentive for anyone with sleep apnea, especially prediabetic individuals, to improve adherence to their treatment for cardiometabolic risk reduction.”

Pamidi and colleagues recruited 39 middle-aged, overweight or obese people with prediabetes and sleep apnea. They randomly assigned 26 of the participants to 2 weeks of CPAP treatment and 13 to a placebo pill to be taken 30 minutes before bedtime.

In the CPAP group, participants wore the device for 8 hours per night. All participants slept in the sleep laboratory and were monitored with all-night sleep recordings. During the day, participants were allowed to leave the laboratory and engage in routine activities.

The researchers assessed glucose metabolism via oral and intravenous glucose tests at baseline and again after the 2-week treatment period. They also measured noradrenaline in the blood and monitored 24-hour blood pressure (BP) while participants were at home.

After 2 weeks, participants demonstrated improved blood glucose control (P=.03) and improved insulin sensitivity (P=.04) with CPAP treatment vs. placebo. Further, the CPAP group had, on average, 27% lower levels of the stress hormone norepinephrine, as well as lower 24-hour BP, than the placebo group.

“Despite the demonstrated efficacy of lifestyle interventions and the availability of many drug treatments, the economic and public health burden of diabetes remains enormous,” senior study author Esra Tasali, MD, assistant professor of medicine at the University of Chicago, said in the release.

“Assessment of sleep apnea should be considered in patients at high risk for diabetes and cardiovascular disease, since our study shows that treatment of sleep apnea can reduce these risks.”


  1. Pamidi S et al. Am J Respir Crit Care Med. 2015;doi:10.1164/rccm.201408-1564OC.