CPAP Treatment Reduces Mortality Risk by 26% in Adults with Type 2 Diabetes and Sleep Apnea
核心洞察
Swedish researchers found that adults with type 2 diabetes (搜索) and obstructive sleep apnea (搜索) who used CPAP (搜索) therapy had a 26% lower risk of all-cause mortality compared to those who never used CPAP.
The large-scale study analyzed data from over 750,000 participants across five national Swedish health registers, following patients for up to 14 years.
Sleep apnea affects up to 80% of adults with diabetes, yet most cases remain undiagnosed, representing a significant overlooked risk factor in diabetes care.
Adults with type 2 diabetes (搜索) and obstructive sleep apnea (搜索) who use continuous positive airway pressure (搜索) (CPAP (搜索)) therapy may significantly reduce their risk of death, according to new Swedish research presented at the European Association for the Study of Diabetes (搜索) annual meeting in Vienna.
The large-scale observational study found that CPAP (搜索) treatment was associated with a 26% lower risk of all-cause mortality among patients with both conditions, highlighting what researchers describe as a "high-risk combination that is often overlooked in diabetes care."
Major Survival Benefit Observed
The research, led by Dr. Jonas Agholme from Linköping University (搜索), analyzed data from five national Swedish health registers spanning 2010 to 2024. The cohort included 12,388 adults with type 2 diabetes (搜索) and OSA (搜索) who were prescribed CPAP (搜索) (31% women; mean age 58 years) and 737,911 adults with type 2 diabetes who were not prescribed CPAP and had unknown OSA status (43% women; mean age 65 years).
During the follow-up period of up to 14 years, 764 adults receiving CPAP (搜索) and 212,336 adults not prescribed CPAP died. After adjusting for baseline demographics and time-varying factors, adults with OSA (搜索) who were prescribed CPAP had a 26% lower risk for all-cause mortality (HR = 0.74; 95% CI, 0.68-0.82; P < .001).
The raw mortality rates revealed a striking difference: only 6.1% of people in the CPAP (搜索) group died compared with nearly 29% of those who were not prescribed CPAP.
Addressing an Overlooked Risk Factor
Sleep apnea represents a significant but underrecognized threat to diabetes patients. The condition affects as many as 80% of adults with diabetes, yet most cases remain undiagnosed. Obstructive sleep apnea (搜索) occurs when throat muscles relax during sleep and block the airway, causing repeated breathing interruptions that lead to poor sleep quality and low oxygen levels.
"These findings underscore the potential importance of identifying and treating sleep apnea in people with type 2 diabetes (搜索)," Agholme told Healio. "If confirmed in further studies, continuous positive airway pressure (搜索) could become an important tool to improve long-term outcomes in this high-risk group."
Clinical Implications and Mechanisms
CPAP (搜索) machines work by delivering pressurized air through a mask, keeping the airway open throughout the night. While CPAP has long been used to treat sleep apnea, its impact on long-term survival has been unclear, particularly for patients with comorbid type 2 diabetes (搜索).
"The findings were encouraging, but not entirely surprising," Agholme said. "Given the strong links between untreated sleep apnea, cardiovascular disease (搜索) and mortality, it is plausible that effective treatment could improve survival. What is new here is that we could demonstrate this association using long-term, real-world data at a national level."
The researcher noted that a post hoc analysis of three randomized trials published in the European Heart Journal found CPAP (搜索) improved cardiovascular outcomes among adults with high-risk OSA (搜索), suggesting those with comorbid type 2 diabetes (搜索) may be considered high risk.
Study Limitations and Future Research
The researchers acknowledge important limitations in their observational study design. "This large real-world study highlights the potential benefits of CPAP (搜索) for people with type 2 diabetes (搜索) and sleep apnea," Agholme said. "The findings suggest that early diagnosis and treatment of sleep apnea could play an important role in improving survival."
However, the study cannot prove that CPAP (搜索) alone caused the survival benefit, and researchers lacked detailed information on patient adherence to CPAP therapy and OSA (搜索) severity levels across different individuals.
"Future research should also examine CPAP (搜索) adherence, OSA (搜索) severity and more detailed clinical data to clarify which patients benefit most," Agholme said. "Unfortunately, it would be very difficult to conduct a randomized trial in this setting, even though that would be the preferred way to establish causality."
The findings provide fresh evidence that managing sleep apnea should be considered an important component of comprehensive diabetes care, potentially offering life-extending benefits beyond improved sleep quality for millions living with both conditions.