The Role of Continuous Positive Airway Pressure (CPAP) Therapy in Obstructive Sleep Apnea With Metabolic Syndrome: Does It Affect the Outcomes?

Background Of all fatalities occurring globally each year caused by noncommunicable diseases, obstructive sleep apnea (OSA) and obesity are associated with an increased risk of sudden death and cardiovascular mortality. Metabolic syndrome and its comorbidities are linked to OSA. The three essential elements of the metabolic syndrome are improper lipid metabolism, hypertension, and insulin resistance. The effect of continuous positive airway pressure (CPAP) on metabolic syndrome elements and related symptoms and whether CPAP therapy helps reverse the syndrome was studied. Methods The present study is prospective pre -post research conducted at a tertiary care center in Nagpur, Hingna, India. The cases included were of moderate to severe or worse OSA, older than 18 years, willing for CPAP therapy with no previous or current CPAP therapy. They had a history of excessive drowsiness during the day. The cases excluded from the study were those with an active, persistent breathing ailment requiring treatment, intervention, or diagnosis of dyslipidemia, diabetes mellitus, or hypertension, past or present, or evidence of damage to the vital end organs. Components of the metabolic syndrome were assessed at the beginning and end of three months of CPAP therapy. Findings Eighty-five cases were enrolled in the study, of which 79 completed it. The majority of cases were male, comprising 48 individuals, accounting for 60.8% of the total cohort. Additionally, 54 cases, representing 68.4% of the group, had hypertension. The average age of the participants was 53.95 years +/- 6.84 years. The BMI mean was 30.4 kg/m2 +/- 4.642, with a waist -hip ratio of 0.964 +/- 0.056 and a neck circumference of 40.66 cm +/- 3.37. The study population scored 12.53 +/- 2,616 on the Epworth Sleepiness Scale. The study population's apnea-hypopnea index/respiratory disturbance index ratio was 16.118 +/- 4.868, a moderate risk score. After three months of CPAP therapy, there was a significant improvement in glycated hemoglobin (HbA1c), tetraiodothyronine (T4), high -density lipoprotein (HDL), and oxygen desaturation, and they were also statistically significant. In the study group, there was a decrease in systolic and diastolic blood pressure of 2.21 mm Hg and 0.26 mm Hg, respectively. Other indicators, including HbA1c, fasting and post -meal blood sugar, triglycerides, and HDL cholesterol, were significantly lower. We observed in the less than 50year -old age group better improvement in systolic blood pressure of 0.49 mm Hg, diastolic blood pressure improvement of 0.32 mm Hg, and fasting blood sugar improvement of 14.59 mg/dl, and in the age group of more than 50, better improvements in post -meal blood sugar of 9.7 mg/dl, along with a statistically significant change in triglyceride with an improvement of 16.26 mg/dl, P value less than 0.05. Interpretation After three months of CPAP therapy, there was a significant improvement in HbA1c, T4, HDL, and oxygen desaturation, and they were also statistically significant. Fourteen (17.72%) cases of post-CPAP therapy no longer met the requirements for the syndrome. There was an improvement in the blood pressure's diastolic and systolic values, fasting and post -prandial sugar levels, HbA1C, and triglyceride levels. Patients over 50 years old showed better improvement in post -meal and triglyceride levels. Females improved blood pressure and triglycerides, whereas males responded better to blood sugar levels.