PURPOSE: Obstructive sleep apnea (OSA) is a common problem with potentially serious health consequences. OSA has been linked to impaired glucose tolerance and increased insulin resistance. The purpose of this study was to evaluate whether metformin (an anti-hyperglycemic drug frequently used to treat insulin resistance) could reverse sleep apnea or prevent its occurrence.
METHODS: This cross-sectional study was performed at Truman Medical Center, a major teaching hospital affiliated with University of Missouri at Kansas City School of Medicine. Multiple linear regression analysis was conducted to establish whether there was a relationship between use of metformin and the severity of OSA (measured by the apnea-hypopnea index) when controlling for age, race, gender, body mass index(BMI) as well as patient’s use of insulin. The analysis included 124 patients (78 females, 46 males) with complete data for each of the variables in the model. Treatment of OSA was provided as per the current standard of care.
RESULTS: When controlling for all other variables in the model, metformin use did not predict AHI(p = 0.647). The potential descriptive and clinical predictors, including race, age, and insulin use were not significantly related to AHI either (p > 0.20 in each case). Gender(p = 0.002)and BMI(p = 0.015) were the only statistically significant predictors of AHI. Males had higher AHI than females, and higher BMI was associated with higher AHI.
CONCLUSIONS: Metformin does not independently improve the severity of apnea-hypopnea events in patients with sleep-disordered breathing.
CLINICAL IMPLICATIONS: Prospective studies will be helpful to determine the effects of treatment of insulin resistance on the severity of OSA.
DISCLOSURE: The following authors have nothing to disclose: Asad Kabir, Fariha Shafi, Aaron Bonham, Abid Bhat
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