{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:52:04Z","timestamp":1781243524459,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Patients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes. The effects of positive airway pressure on glycemic control are contradictory. We therefore evaluated the change in glycated hemoglobin (HbA1c) in a large cohort of OSA patients after long\u2010term treatment with positive airway pressure. HbA1c levels were assessed in a subsample of the European Sleep Apnea Database [n=1608] at baseline and at long\u2010term follow up with positive airway pressure therapy (mean 378.9\u00b1423.0 days). In a regression analysis, treatment response was controlled for important confounders.<\/jats:p><jats:p>Overall, HbA1c decreased from 5.98\u00b11.01% to 5.93\u00b10.98% (p=0.001). Patient subgroups with a more pronounced HbA1c response included patients with diabetes (\u22120.15\u00b11.02, p=0.019), those with severe OSA baseline (\u22120.10\u00b10.68, p=0.005), those with morbid obesity (\u22120.20\u00b10.81, p&lt;0.001). The strongest HbA1c reduction was observed in patients with a concomitant weight reduction &gt;5 kilos (\u22120.38\u00b10.99, p&lt;0.001). In robust regression analysis, severe OSA (p=0.038) and morbid obesity (p=0.005) at baseline, and weight reduction &gt;5 kilos (p&lt;0.001) during follow up were independently associated with a reduction of HbA1c following PAP treatment. In contrast, PAP treatment alone without weight reduction was not associated with significant Hb1Ac reduction.<\/jats:p><jats:p>In conclusion, positive airway pressure therapy is associated with HbA1c reduction in patients with severe OSA, in morbidly obese patients. and most obviously in those with significant weight lost during the follow\u2010up. Our study underlines the importance to combine positive airway pressure use with adjustments in lifestyle to substantially modify metabolic complications in OSA.<\/jats:p>","DOI":"10.1111\/jsr.13331","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T07:29:57Z","timestamp":1620977397000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4507-9851","authenticated-orcid":false,"given":"Mehmet Sezai","family":"Tasbakan","sequence":"first","affiliation":[{"name":"Department of Chest Diseases Ege University Faculty of Medicine Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7405-1682","authenticated-orcid":false,"given":"Ludger","family":"Grote","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center Center for Sleep and Wake Disorders Sahlgrenska University Hospital Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hedner","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center Center for Sleep and Wake Disorders Sahlgrenska University Hospital Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Arthur","family":"Kvamme","sequence":"additional","affiliation":[{"name":"Sleep Laboratory ENT Department F\u00f8rde Central Hospital F\u00f8rde Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Verbraecken","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sleep Disorders Centre Antwerp University Hospital and University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5927-2738","authenticated-orcid":false,"given":"Walter T.","family":"McNicholas","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine School of Medicine St Vincent's Hospital Group University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Roisman","sequence":"additional","affiliation":[{"name":"Sleep Disorders Centre Hospital Antoine\u2010Beclere Clamart France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruzena","family":"Tkacova","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Tuberculosis Faculty of Medicine P.J. Safarik University Kosice Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4875-7796","authenticated-orcid":false,"given":"Maria R.","family":"Bonsignore","sequence":"additional","affiliation":[{"name":"PROMISE Dept University of Palermo Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarja","family":"Saaresranta","sequence":"additional","affiliation":[{"name":"Division of Medicine Department of Pulmonary Diseases Department of Pulmonary Diseases and Clinical Allergology Turku University Hospital and Sleep Research Centre University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paschalis","family":"Steiropoulos","sequence":"additional","affiliation":[{"name":"Sleep Unit Department of Pneumonology Democritus University of Thrace Alexandroupolis 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