CPAP (continuous positive airway pressure) is considered the frontline, gold standard treatment for sleep apnea. In fact, for many doctors, it’s the only treatment. However, some doctors are noting that CPAP fails to treat some of the serious consequences of sleep apnea, leaving patients with ongoing health problems. Doctors are now struggling to explain why CPAP can’t reverse these serious and potentially deadly effects of sleep apnea.
Metabolic Consequences of Sleep Apnea
Sleep apnea disrupts many body functions that are supposed to take place during sleep. One of these is regulating your body’s hormones that control the use and storage of energy.
The effects of this include greater weight gain, but also less ability to dispose of blood sugar (glucose), and a lower release of insulin. The relationship between the two conditions even seemed to be dose-dependent: the more severe your sleep apnea, the worse your ability to regulate your blood sugar.
The result is that people with sleep apnea are more likely to experience elevated levels of blood sugar and develop diabetes. Since diabetes is linked to many secondary health conditions, including heart attack, stroke, neurological damage, and blindness, it’s important to control blood sugar.
Unfortunately, CPAP doesn’t seem to be capable of helping this for many patients.
Although there are decades of research into the effectiveness of CPAP, including numerous randomized controlled trials, there is not enough evidence to suggest that CPAP is effective at helping people control their blood sugar.
What makes this baffling to scientists is that animal models predict that CPAP should work. When they look at animal models, they find that hypoxia–low oxygen levels, as experienced by people with sleep apnea–leads to elevated blood sugar levels. However, when the normal levels of oxygen are restored in animals, blood sugar levels go back to normal.
To try and explain why this doesn’t happen for humans, researchers propose three possible solutions:
- There’s a problem with the experiments
- People don’t comply with CPAP
- Sleep apnea causes permanent damage to the metabolism
Right now, they don’t know which of these factors is responsible for the seeming disconnect or if it’s a mix of all three.