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CPAP improves diabetes control in patients with sleep apnoea

Use of continuous positive air pressure (CPAP) led to long-term improvements in blood pressure and blood glucose in patients with obstructive sleep apnoea and type 2 diabetes, according to a five-year study in UK general practice.

Researchers said the CPAP treatment also improved patients’ quality of life at an acceptable cost to the NHS.

The study, published in Diabetes Care, looked at the outcomes of 150 patients with type 2 diabetes who received treatment for obstructive sleep apnoea with CPAP over five years, compared with those of 150 matched control patients who did not receive the treatment.

The CPAP-treated patients had lower systolic and diastolic blood pressure at five years, and successively lowered HbA1c levels over five consecutive years, compared with the untreated patients.

CPAP was also associated with improved quality of life over the five years, with a gain of 0.27 quality-adjusted life years (QALYs) per patient.

At a cost to the NHS of £4,141 for each patient over five years, the researchers calculated the cost per QALY gained with CPAP was £15,337.

The study’s authors, led by Dr Julian Guest at King’s College London, concluded: ‘Initiating treatment with CPAP in obstructive sleep apnoea patients with type 2 diabetes leads to significantly lower blood pressure and better controlled diabetes and affords a cost-effective use of NHS resources.

‘These observations have the potential for treatment modification if confirmed in a prospective study.’

Diabetes Care 2014; available online 4 April