Evidence mapPaperPMID 28095965Full record

ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2017

VAMONOS (Veterans Affairs' Metabolism, Obstructed and Non-Obstructed Sleep) Study: Effects of CPAP Therapy on Glucose Metabolism in Patients with Obstructive Sleep Apnea.

Octavian C Ioachimescu, Jeremy Anthony, Tina Constantin, Mary-Margaret Ciavatta, Kandace McCarver, Mary Ellen Sweeney

Abstract read
In one paragraph

Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019
    Pooled it
  3. Trial
  4. Effects of Medical Therapy on Mild Obstructive Sleep Apnea in Adult Patients.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019
    Trial
  5. Mechanisms Linking Sleep-Disordered Breathing and Cardiometabolic Disease Risk.Arteriosclerosis, thrombosis, and vascular biology · 2026
    Review
  6. Article
  7. Review
  8. Article
  9. Bidirectional relationships of comorbidity with obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2022
    Review
  10. Article
  11. Use of the WatchPAT to detect occult residual sleep-disordered breathing in patients on CPAP for obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Article
  12. Article
  13. Obstructive Lung Disease and Obstructive Sleep Apnea (OLDOSA) cohort study: 10-year assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Article
  14. The Veterans Affairs Continuous Positive Airway Pressure Use and Diabetic Retinopathy Study.Optometry and vision science : official publication of the American Academy of Optometry · 2019
    Article
  15. The Epidemiology of Sleep and Diabetes.Current diabetes reports · 2018
    Review
  16. Article
  17. The Effect of OSA Therapy on Glucose Metabolism: It's All about CPAP Adherence!Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Octavian C IoachimescuAtlanta VA Medical Center, Decatur, GA.
Jeremy AnthonySt. Mary's Medical Group, Athens, GA.
Tina ConstantinAtlanta VA Medical Center, Decatur, GA.
Mary-Margaret CiavattaAtlanta VA Medical Center, Decatur, GA.
Kandace McCarverAtlanta VA Medical Center, Decatur, GA.
Mary Ellen SweeneyAtlanta VA Medical Center, Decatur, GA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesObstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) are prevalent disorders that pose increased risk of cardiovascular disease and death. The objective of this study was to clarify if continuous positive airway pressure (CPAP) therapy for OSA affects T2DM control and emergence.

methodsPoint-of-care, comparative effectiveness study; cross-sectional and longitudinal analyses.

resultsOur cohort included 928 consecutive patients; 13% were women; 36% were Caucasians and 61% African-Americans. OSA was diagnosed in approximately 738 patients and CPAP was initiated in 718 patients; median duration of therapy was 5 mo (25% to 75% interquartile range [IQR] 3-14). Patients with OSA used CPAP therapy for a median duration of 4.8 h, 34.5% of the nights. Adherence to CPAP was prespecified as follows: good (≥ 70% nights and ≥ 4 h/night), excellent (≥ 80% nights and ≥ 6 h/night) or outstanding (≥ 90% of nights and 8 h/night). Based on objective data, good, excellent, and outstanding compliance were found in only 30%, 20%, and 6%, respectively. Three percent of subjects without CPAP follow-up and less than 4% of those nonadherent to CPAP therapy (based on the established criteria) developed incident T2DM. Incident T2DM developed in only 0.8% of those with good compliance and in none (0%) of those in the excellent and outstanding groups. During follow-up, median weight change was +0.3 kg (IQR -1.8 to 2.7).

conclusionsWe found that an outstanding compliance to CPAP reduced fasting blood glucose in patients with OSA. Longitudinally, higher levels of therapeutic adherence may affect the rate of incident impaired fasting glucose, prediabetes, and T2DM, despite the observed weight gains. COMMENTARY: A commentary on this article appears in this issue on page 365.

Indexed as

VeteransComparative Effectiveness ResearchContinuous Positive Airway PressureCross-Sectional StudiesFemaleGeorgiaGlucoseHumansLongitudinal StudiesMaleMiddle AgedPoint-of-Care SystemsPolysomnographyPrediabetic StateRetrospective StudiesSleep Apnea, ObstructiveGlucoseCPAP therapydiabetesobstructive sleep apneaprediabetessleep apnea

Identifiers

PMID28095965
PMCPMC5337593

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.