Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy
Journal of Metabolic Health (previously Journal of Insulin Resistance)
| Field | Value | |
| Title | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy | |
| Creator | Crofts, Catherine A.P. Neill, Alister Campbell, Angela Bartley, Jim White, David E. | |
| Description | Background: The global pandemic of metabolic disease is worsening. The metabolic theory of obesity proposes that hormonal changes, especially hyperinsulinaemia, precede metabolic disease development. Although quality sleep is recognised as a key factor for good health, less is known about disrupted sleep as a risk factor for hyperinsulinaemia. Aim: To explore the relationship between sleep, especially sleep architecture and the nasal cycle, on insulin secretion in obstructive sleep apnoea (OSA) with comorbid metabolic disease. This review includes a discussion of the potential role of Rest-Activity-Cycler positive airway pressure (RACer-PAP), a novel non-pharmacological OSA treatment strategy. Methods: A narrative review of all the relevant papers known to the authors was conducted. This review also included results from a polysomnographic sleep clinic pilot study (n = 3) comparing sleep efficiency of RACer-PAP to nasal continuous positive airways pressure (n-CPAP) in OSA patients. Results: Metabolic disease is strongly associated with disturbed sleep. Sleep architecture influences cerebral hormonal secretion, lateral shifts in the autonomic nervous system and nasal airflow dominance. Disturbed sleep shortens short-wave sleep periods, decreasing insulin sensitivity and glucose tolerance. Improvements to metabolic function during n-CPAP treatment are inconsistent. If RACer-PAP demonstrates superior effects on sleep architecture and autonomic function, it may offer advantages in OSA patients with comorbid metabolic disease. Conclusion: Improving sleep architecture by maintaining the nasal cycle proposes a novel non-pharmacological treatment paradigm for treating OSA with comorbid metabolic disease. Research is required to demonstrate if RACer-PAP therapy influences whole night sleep architecture, sympathovagal balance and markers of metabolic disease. | |
| Publisher | AOSIS | |
| Date | 2018-03-28 | |
| Identifier | 10.4102/jir.v3i1.34 | |
| Source | Journal of Metabolic Health; Journal of Insulin Resistance: Vol 3, No 1, 2018; 6 pages 2960-0391 n/a | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://journalofmetabolichealth.org/index.php/jmh/article/view/34/106
https://journalofmetabolichealth.org/index.php/jmh/article/view/34/105
https://journalofmetabolichealth.org/index.php/jmh/article/view/34/107
https://journalofmetabolichealth.org/index.php/jmh/article/view/34/101
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