Effects of CPAP on energy expenditure in obese obstructive sleep apnoea patients: A pilot study.
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SUBMITTER: Shechter A
PROVIDER: S-EPMC5193470 | biostudies-literature | 2015 Nov-Dec
REPOSITORIES: biostudies-literature
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Effects of CPAP on energy expenditure in obese obstructive sleep apnoea patients: A pilot study.
Shechter Ari A Pham Tiffany T Rising Russell R St-Onge Marie-Pierre MP
Obesity research & clinical practice 20150911 6
We conducted a placebo-controlled crossover pilot study investigating the effects of 2 mo of active and sham continuous positive airway pressure (CPAP) on energy expenditure (EE) via whole-room indirect calorimetry in three obese obstructive sleep apnoea (OSA) patients. Total 24-h (active: 2970 ± 254 kcal/d, sham: 2705 ± 217 kcal/d; p = 0.015) and mean sleeping (active: 1.60 ± 0.20 kcal/min; sham: 1.47 ± 0.17 kcal/min; p = 0.038) EE were significantly increased after active vs. sham CPAP. Findin ...[more]
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Project description:Obstructive Sleep Apnoea Syndrome (OSAS) is a condition of obstruction, apneas and arousals while sleeping. It has been suggested that OSAS independently influences glucose metabolism. The main treatment for OSAS is continuous positive airways pressure (CPAP).To assess the effects of CPAP on insulin resistance and glucose metabolism.We searched Medline, Embase and the Cochrane Controlled Trial Register (January 2010).We included randomised and non-randomised trials comparing CPAP with inactive control or placebo CPAP in adults with OSAS.Two authors independently assessed trial quality and extracted data. Parallel and crossover group trials were analysed separately. A meta-analysis was carried out.Three parallel group and two cross-over randomised trials and one controlled trial were included investigating 296 participants. Sample sizes ranged from n=13 to n=102 participants, age was 18 to 75 years, mean body mass index (BMI) 27.2 kg/m² to 37.1 kg/m², mean apnoe hypopnoe index (AHI) 29.7 to 39.7 events per hour, mean dips >4% in arterial oxygen saturation per hour of sleep 1 to 42.7 events. The studies' methodological quality varied. Follow-up ranged from 4 to 12 weeks. Various endpoints were investigated. CPAP did neither influence plasma insulin levels nor HOMA-index, adiponectin levels or HbA1c value. One study reported a significant positive effect on the insulin sensitivity index (1.68%/min, 95% CI 0.3 to 3.06).This systematic review does not support the hypothesis that OSAS independently influences glucose metabolism. Sufficiently powered, long-term randomised controlled trials defining changes of insulin resistance as primary endpoint are needed.
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Project description:Background:Current continuous positive airway pressure (CPAP) devices can be monitored remotely; however, in-person visits are kept for clinical follow-up in order to promote CPAP use and resolve potential side-effects. Mobile health is a promising way to provide remote and easy clinical control for CPAP follow-up and support. We aimed to evaluate the feasibility and acceptance by obstructive sleep apnoea (OSA) patients and healthcare professionals of a newly designed mobile app (Appnea-Q) to promote clinical control through a self-monitoring tool for patients with CPAP supervised by sleep professionals. Methods:Appnea-Q incorporates a simple follow-up questionnaire with automated responses, together with frequent problems and lifestyle recommendations sections. Feasibility, acceptance and usefulness were assessed. First, an internal validation was performed during outpatient CPAP follow-up visits with sleep professionals from various sleep units. Second, an external validation was performed in a subgroup of 15 patients at home. Results:Most patients (n=75) considered the app useful and were willing to use it and recommend it (72-88%). Up to 64.87% agreed on its capacity to reduce hospital visits. Appnea-Q was rated as acceptable (79.37±19.29) by the system usability score. Sleep professionals (n=30) concurred on its usefulness for OSA patient follow-up, particularly during the first month of CPAP therapy. The external validation showed its feasibility among 11 out of 15 patients and their data were received accordingly on the professionals' web platform. Conclusions:According to our validation process, and the viewpoints of the patients and professionals, our new mobile app is a feasible and well-received tool for personal OSA management. Future clinical trials should substantiate its performance and cost-effectiveness in the clinical arena.
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