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Normal and elevated HbA1C levels correlate with severity of hypoxemia in patients with obstructive sleep apnea and decrease following CPAP treatment

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Abstract

Purpose

Sleep apnea is associated with higher HbA1C levels in patients with and without diabetes but whether its severity correlates with HbA1C levels ranging from normal to abnormal is less clear. Also, the effect of continuous positive airway pressure (CPAP) treatment on HbA1C levels in patients with sleep apnea is controversial.

Methods

Thirty consecutive patients with obstructive sleep apnea were studied. None of the patients was previously diagnosed with diabetes. All patients underwent overnight polysomnography and HbA1C levels were determined. Patients were subdivided into three groups according to their HbA1C levels: <6% (n = 10), 6–6.5% (n = 10), and ≥6.5% (n = 10). Polysomnography and determination of HbA1C level were repeated in patients with severe sleep apnea (n = 12) following 3–5 months of CPAP treatment.

Results

HbA1C levels across the spectrum from normal to abnormal correlated with severity of hypoxemia (average SpO2, r = −0.43, p = 0.019 and percent time with SpO2 < 90%, r = 0.48, p = 0.007). HbA1C levels decreased from a mean of 6.47 ± 0.67% to a mean of 6.28 ± 0.51%, p = 0.038 in 12 patients with severe sleep apnea following 3–5 months of CPAP treatment.

Conclusions

The severity of hypoxemia in patients with sleep apnea correlates with HbA1C levels ranging from normal to pre-diabetes and diabetes. CPAP treatment for 3–5 months decreases HbA1C levels in patients with severe sleep apnea.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. The Institute of Pulmonary Medicine, Assaf Harofeh Medical Center (affiliated to the Sackler Faculty of Medicine, Tel Aviv University), Zerifin, 70300, Israel

    Isaac Shpirer & David Stav

  2. Department of Pediatrics, Assaf Harofeh Medical Center (affiliated to the Sackler Faculty of Medicine, Tel Aviv University), Zerifin, 70300, Israel

    Arnon Elizur

  3. The Sleep Laboratory, Assaf Harofeh Medical Center (affiliated to the Sackler Faculty of Medicine, Tel Aviv University), Zerifin, 70300, Israel

    Isaac Shpirer & Arnon Elizur

  4. Department of Internal Medicine “C” and Diabetes Unit, Assaf Harofeh Medical Center (affiliated to the Sackler Faculty of Medicine, Tel Aviv University), Zerifin, 70300, Israel

    Micha J. Rapoport

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  1. Isaac Shpirer
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Correspondence to Arnon Elizur.

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Shpirer, I., Rapoport, M.J., Stav, D. et al. Normal and elevated HbA1C levels correlate with severity of hypoxemia in patients with obstructive sleep apnea and decrease following CPAP treatment. Sleep Breath 16, 461–466 (2012). https://doi.org/10.1007/s11325-011-0525-x

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  • DOI: https://doi.org/10.1007/s11325-011-0525-x

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