CPAP Makes No Difference (with Diabetes)
In this study, researchers in the US and Australia looked at 298 type 2 diabetes patients who were recently diagnosed with sleep apnea. These diabetes patients, whose diabetes was “relatively well controlled” were randomly assigned to receive either usual care or usual care plus CPAP.
They found that CPAP didn’t improve glycemic control for the diabetes patients over usual care.
However, they did see some positive improvements from the use of CPAP for these patients, such as:
- Greater reduction in blood pressure
- Improvement of daytime sleepiness
However, patients on and off of CPAP had about the same quality of life scores.
Accounting for the (Lack of) Results
So, how do researchers account for the fact that their results differed from those of previous studies? First, they said, it may be a problem with CPAP and CPAP compliance. The bar for CPAP compliance is set very low, requiring only an average of four hours a night for 21 days a month. Some researchers have suggested that this compliance standard is not adequate for diabetes control because metabolic regulation occurs during REM sleep, which occurs primarily in the second half of the night. A patient could be technically compliant with CPAP but never be using it during the REM-heavy sleep times.
Another potential problem is that the study focused only on diabetics who had their condition relatively under control. However, CPAP might make more of a difference among people whose diabetes is poorly controlled.
Finally, researchers suggested that sleep apnea might play a strong role in the development of diabetes, but not significantly impact control of the condition.
Better Compliance with Oral Appliances
If the problem lies with CPAP and CPAP compliance, then oral appliances might be a much better choice for people who have both sleep apnea and diabetes. Oral appliances that can monitor usage show that almost everyone with oral appliances (95%) meet the CPAP compliance standard, and a full 84% achieve the “all night every night” standard. This would make for more treatment during the REM-heavy second half of the night.
Oral appliances might also help with quality of life because users won’t experience the negative side effects of CPAP.
If you are using CPAP, but aren’t happy with the treatment or its results, you may benefit from an oral appliance. Please call (402) 493-4175 for an appointment with an Omaha sleep dentist at the Advanced Dental Sleep Treatment Center.