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Continuous positive airway pressure for obstructive sleep apnoea in T2D

UK healthcare professionals are increasingly aware of obstructive sleep apnoea (OSA) in overweight people with diabetes. NICE has recommended continuous positive airway pressure (CPAP) as a treatment for adults with moderate or severe symptomatic obstructive sleep apnoea or hypopnoea syndrome. The authors of this UK-based study assessed clinical outcomes and cost-effectiveness of using CPAP to manage OSA in people with type 2 diabetes, concluding that it significantly lowers blood pressure and leads to better diabetes control.

by Colin Kenny, GP, Dromore 

NICE has noted that people with OSA may have impaired alertness, cognitive impairment and excessive daytime sleepiness. This can have effects on both health and driving. In the current study, 150 CPAP-treated individuals with OSA and type 2 diabetes were randomly selected from The Health Improvement Network (THIN) general practice database and matched with 150 people with OSA and type 2 diabetes from the same database who were not treated with CPAP. The researchers looked at outcomes of patient management in both groups over 5 years, and the cost-effectiveness of CPAP compared with no CPAP treatment was estimated. 

CPAP gave significantly lower blood pressure at 5 years and increasingly lower HbA1c levels over consecutive years compared with untreated individuals with OSA. The CPAP intervention was judged to be cost-effective. While we await a prospective trial, it would appear to be worthwhile sending people with type 2 diabetes who have OSA for an assessment for CPAP. 

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