Most Read Articles
01 Jun 2015
Long-term oral testosterone undecanoate significantly improved IPSS quality of life scores in a 1-year, randomised, multicentre, double-blind trial among aging hypogonadal men.
Rachel Soon, 01 Jun 2016

The inclusion of statins in managing chronic kidney disease (CKD) may help reduce patient mortality from stroke and possibly other cardiovascular events, according to an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Rachel Soon, 01 Jun 2016

Patients with hypercholesterolaemia with unchanging LDL-cholesterol levels after 6 weeks of statin treatment should be actively assessed for either statin intolerance or resistance, says an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Prof. Cyrus Rustam Kumana, 07 Jul 2016

This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.

CPAP withdrawal-induced OSA ups free fatty acids, glucose, cortisol during sleep

21 Sep 2017

Cessation of continuous positive airway pressure (CPAP) elicits the occurrence of obstructive sleep apnoea (OSA) associated with sympathetic and adrenocortical activation thereby increasing plasma free fatty acids (FFAs) and glucose during sleep, a recent study has found. Repeated exposure to these metabolic changes may lead to diabetes and cardiovascular disease.

A randomized crossover trial of CPAP vs CPAP withdrawal, including 31 patients with moderate to severe OSA acclimated to CPAP, was conducted to assess the impact of OSA on frequently sampled nocturnal metabolic markers, such as plasma FFAs, glucose, insulin, triglycerides, cortisol and lactate, as well as glucose production, oral glucose tolerance, blood pressure (BP), endothelial function, cholesterol and high-sensitivity C-reactive protein (hsCRP).

Patients underwent polysomnography while sleeping with therapeutic CPAP, or after CPAP withdrawal, in random order. Researchers tested venous blood at approximately 20-minute intervals on both nights. Moreover, the assessed glucose kinetics with an infusion of 6,6-[2H2]glucose on 11 patients.

CPAP withdrawal triggered the recurrence of OSA associated with hypoxaemia, sleep disruption and heart rate elevation, as well as dynamically increased nocturnal FFA (p=0.007), glucose (p=0.028) and cortisol (p=0.037), in proportion to respiratory event frequency, heart rate elevation or sleep fragmentation. Diabetes predisposed to glucose elevation.

In addition, CPAP withdrawal led to higher systolic BP (p=0.017) and augmentation index (p=0.008). However, it did not affect insulin, triglycerides, glucose production, oral glucose tolerance, cholesterol or hsCRP.

OSA is associated with diabetes and cardiovascular disease. This association may be related to metabolic changes that transpire during sleep in OSA,” researchers said.

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Most Read Articles
01 Jun 2015
Long-term oral testosterone undecanoate significantly improved IPSS quality of life scores in a 1-year, randomised, multicentre, double-blind trial among aging hypogonadal men.
Rachel Soon, 01 Jun 2016

The inclusion of statins in managing chronic kidney disease (CKD) may help reduce patient mortality from stroke and possibly other cardiovascular events, according to an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Rachel Soon, 01 Jun 2016

Patients with hypercholesterolaemia with unchanging LDL-cholesterol levels after 6 weeks of statin treatment should be actively assessed for either statin intolerance or resistance, says an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Prof. Cyrus Rustam Kumana, 07 Jul 2016

This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.