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Metabolic disorders and sleep


Authors: Martin Pretl 1;  Zuzana Lattová 2;  Andrea Plíhalovájan Polák 3 3,2,3;  Kateřina Westlake 2,3,4
Authors‘ workplace: Inspamed, s. r. o., neurologická ambulance a spánková poradna, Institut spánkové medicíny, Praha 1;  Ústav patofyziologie 3. LF UK v Praze 2;  2. interní klinika 3. LF UK a FN Královské Vinohrady, Praha 3;  Diabetologická ambulance, Diabetologie Praha, s. r. o. 4
Published in: Čas. Lék. čes. 2019; 158: 185-192
Category: Review Article

Overview

Epidemiologic studies show that both atypical sleep time and obstructive sleep apnea (OSA) are independently associated with higher risk of metabolic disease development, particularly obesity and type 2 diabetes mellitus (T2DM). OSA is an independent risk factor for cardiovascular mortality, which is amongst the most common causes of death in T2DM. It is advisable to screen patients for OSA due to the high prevalence of the disease in T2DM patients. For screening are recommended questionnaires and home sleep monitoring. OSA diagnosis is then verified by home sleep apnea testing (using polygraphy) or by polysomnography.

Positive airway pressure (PAP) is a gold standard in the treatment of moderate and severe OSA. PAP prevents hypoxia and sleep fragmentation, eliminating excessive daytime sleepiness and decreasing the risk of cardiovascular diseases. Studies have not yet shown an effect of PAP treatment on T2DM compensation and glucose metabolism. Despite this a positive effect of PAP on insulin resistance and glucose tolerance has been proven in patients with prediabetes. PAP therapy is advised in obese patients of the central type with OSA, bariatric surgery has been proven to decrease the severity of OSA.

Keywords:

mass screening – obstructive sleep apnea – sleep time – intermittent hypoxia – Glucose metabolism – continuous positive airway pressure – central obesity


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