sleep apnea

Type 2 diabetes and sleep apnea are closely related - this man wearing a CPAP mask should probably get tested for type 2 diabetes.

Correlations Between Type 2 Diabetes and Sleep Apnea

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You may already know that sleep apnea is a breathing issue that actually affects over 22 million Americans in some form or another. However, what you may not know is that sleep apnea can be an early sign of diabetes developing within the body.  This ultimately comes down to the concentration of oxygen within the bloodstream. Below, we’ve compiled all the details you need to know regarding type 2 diabetes and sleep apnea how presence of each disease affects the other.

Type 2 Diabetes

Firstly, this is a chronic condition that increases the blood glucose levels to unnatural highs. Over time, the body becomes immune to the effects of insulin or it fails to use the store your body offers and this leads to several consequences. At first, the pancreas will step in to make up for the extra insulin. However, this isn’t a sustainable solution and not enough insulin is produced to maintain natural levels. Unfortunately, the condition is actually largely preventable which means our lifestyles are to blame including obesity and history of the disease in the family.

Sleep Apnea

Also known as obstructive sleep apnea (OSA), this is a sleep disorder that directly affects the breathing during the night. With snoring and sudden wakefulness as the two main symptoms, OSA can actually lead to several health complications including heart disease and, of course, diabetes. In addition to this, it can impact people who are obese or have a history of the issue in the family, much like diabetes.

Type 2 diabetes and sleep apnea can both be triggered by obesity and stress. This man is lying down with a CPAP mask on, and he has sleep apnea.

Obesity and stress are the two most common causes of both type 2 diabetes and sleep apnea.

The Correlation Between Type 2 Diabetes and Sleep Apnea

Scientists have actually known about the correlation between type 2 diabetes and sleep apnea for three and a half decades. Proving a significant percentage of diabetics also suffered from sleep breathing disorders, interest grew and we’ve been learning more about the relationship ever since.

According to the Center for Disease Control and Prevention, nearly 26 million people suffer from diabetes with up to 95% of these people having the type 2 variety. Of this huge number, 7 in every 10 also have OSA and one study even suggested a total of 72%, which is significant.

Why? Most commonly, the issue starts with sleep apnea. A certain percentage of people don’t manage this condition very well, making it very difficult for our bodies to control the blood sugar levels. As the condition gets worse and we still don’t manage sleep apnea effectively, type 2 diabetes and sleep apnea will both cause more complications as a result.

In addition to this, there’s also a link between the two with excess stress and body fat. When we wake up during the night due to sleep apnea, this causes frustration and stress because we aren’t able to relax before we fall asleep (knowing it will come during the night), leaving us feeling tired the next day. With this interrupted sleep, our bodies are strained beyond comfortable levels and this will further increase blood sugar levels.

Obesity

As we saw previously, obesity is commonly involved in both these issues. For people who are overweight and develop sleep apnea, any excess fat around the neck will actually obstruct the airways and exacerbate the problem. Overnight, your breathing will be interrupted further and this leads to less sleep and increased stress. In turn, this causes a higher risk for both type 2 diabetes and sleep apnea.

Does it Work in Reverse?

With this in mind, can it work the other way where diabetes causes sleep apnea? Ultimately, people with diabetes tend to have poorer sleep than most anyway and this is because the high glucose levels lead to the kidneys excreting excess sugar during the night. In addition to this, diabetes sufferers can struggle with leptin resistance which depresses the respiratory function and causes a destabilization in breathing patterns.

For this reason, people with either condition will automatically be checked for the other because they’re so closely related. As one occurs, it will lead to the other, with each disease causing a positive feedback loop in the other, and your body will continue on a negative spiral until treated.

Careful Management

All things considered, the best solution to both problems will always be careful management after diagnosis. With OSA, the doctor is likely to recommend a CPAP machine while type 2 diabetes needs to be controlled via blood glucose levels and diet, exercise, and injections (if necessary). Thanks to a recent study at the University of Chicago, we actually know that CPAP machines can reduce blood glucose levels which cuts off this negative spiral and prevents the conditions from worsening.

An alarm clock with sheep (counting sheep) to denote the consequences of hypersomnia.

Hypersomnia: Causes and Treatment

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Characterized as either excessive amounts of time spent tired or asleep during the day, hypersomnia affects around 0.5% of Americans each and every year. Although this doesn’t sound like a huge amount, it accounts for 1.6 million people and this is only the number that seek treatment (the amount who don’t seek medical treatment is thought to be significant). In fact, the National Sleep Foundation believes 40% of us to experience the symptoms of hypersomnia to some degree.

In terms of the health condition itself, the sufferers have trouble staying awake through the day whether it’s at work, at home, or even while driving. While the problem is purely related to sleep, it has all sorts of side-effects such as a lack of energy and trouble concentrating on even simple tasks.

Causes of Hypersomnia

When looking for causes, it’s hard to look past two other sleep conditions; narcolepsy and sleep apnea. While the former is related to daytime sleepiness once again, the latter deals with interruptions within the normal breathing patterns as you sleep. Both of these issues lead to hypersomnia and make it hard to stay awake during daylight.

After this, we could also point to the following:

  • Being Overweight
  • Alcohol or Drug Abuse
  • Lack of Sleep (Night)
  • Prescription Drugs (Antihistamines or Tranquilizers)
  • Neurological Diseases (Parkinson’s or Multiple Sclerosis)
  • Depression
  • Genetics

With so many different causes, it’s important to see a medical professional who can assess the issue and ask the right questions. While the internet and fantastic guides like this can give you an overview, we can’t provide you with personalized advice. In truth, your hypersomnia could be a combination of these causes.

A sleeping man on an orange background, to suggest hypersomnia in the daytime hours.

Hypersomnia can be caused by many different issues so it’s important for a healthcare professional to assess what they are and provide you with the treatment you need.

Treatment

When you first spot the pattern of drowsiness throughout the day, this is where your doctor should come in. Initially, they’ll discuss your personal life, including your sleeping habits, to get a better idea of why this might be happening. In addition to your sleep, they might also ask whether you’ve been through a stressful situation recently or whether you’re currently taking any drugs (prescription or otherwise).

If they can pinpoint the issue immediately, they’ll start working towards a solution as soon as possible. If not, they may take blood tests, a CT scan, and even a polysomnography; this is a sleep test where your brain waves are measured alongside your heart rate, breathing, and oxygen levels within the blood. If necessary, an EEG (electroencephalogram) could examine your electrical brain activity.

Depending on the cause, the doctor will take appropriate steps as a solution and this could involve stimulants, Provigil, Xyrem, or antidepressants. As mentioned, the applicable treatment will entirely depend on the issue.  Sleep apnea, for example, may require a CPAP (continuous positive airway pressure). With this treatment, you’ll wear a small mask over your face and this goes directly into a machine. Through the night, you’ll be provided with a flow of air to the nostrils which counteracts the condition. As the air flows into the nostrils, it keeps the airways open and you shouldn’t wake up in the night.

If you’ve been offered medication in the past and this didn’t work, don’t worry because they can switch your dosage or try a different solution. Sometimes, people need a heavier dose or a slightly different drug if the first didn’t have the intended reaction within the body. Often, people try medication once, feel disappointed with the results, and then forget the doctor altogether but this doesn’t have to be the case.

As we’ve seen, hypersomnia can also be caused by weight issues and a lack of sleep at night; sometimes, we get into the habit of staying up until 2am before the alarm then goes off for work at 6am. Although we all need different levels of sleep to operate, a sleep pattern of this nature won’t do any good at all. If your issue is one of these two causes, your doctor will recommend an adjustment to your lifestyle. Once again, it all depends on the cause but your solution might be a reduction in caffeine, more sleep at night, a diet to lose weight, less alcohol, etc.

If you’re currently suffering from hypersomnia, be sure to get medical attention because you don’t want to self-diagnose and then choose the wrong treatment. Instead, get assessed and have yourself back up to full health as soon as possible!

Man is snoring in bed due to sleep apnea, which is suspected to lower life expectancy.

How Does Sleep Apnea Affect Your Life Expectancy?

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Man is snoring in bed due to sleep apnea, which is suspected to lower life expectancy.

Can sleep apnea put your life expectancy in jeopardy?

The average life expectancy is 78.8 years, according to the CDC. The advancement of modern medicine and technology has made living this long possible. However, bad habits and diseases continue to fight against the progress we have made. That’s why it’s important to know what diseases and conditions lower your life expectancy.

Even conditions that prove to be a minor inconvenience can have a long-term impact on your health. Sleep apnea, for instance, is a troublesome condition that is often overlooked. Now, scientists are concerned that disorder’s influence on your quality of life can also affect how long you live. (more…)

A man in bed, laying down, with a sleep apnea condition.

Disposable Patch Identifies Sleep Apnea Condition

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A man in bed, laying down, with a sleep apnea condition.

There may be a new way to detect your sleep apnea condition.

One of the most difficult aspects of the sleep apnea condition is identifying it. This disorder often goes undiagnosed, as no blood test exist to indicate if an individual has sleep apnea. Even worse, apparent symptoms, like snoring or pauses in your breath, only occur during sleep. Unless a person with sleep apnea is being monitored after they go to bed, they are otherwise unaware of their symptoms.

While sleep apnea may seem like a harmless condition but over time it significantly effects the body. Left untreated, sleep apnea leads to an increased risk of high blood pressure, heart attack, stroke, obesity, and diabetes. The disorder can also lead to an increased chance of having work-related or driving accidents. With an early diagnosis, patients can avoid these comorbidities from developing. A new disposable diagnostic patch hopes to make identifying the condition a reality.

Detecting One’s Sleep Apnea Condition

The skin-adhesive diagnostic patch (known as the SomnaPatch) monitors several factors to determine if a patient has a sleep apnea condition. By measuring nasal pressure, blood oxygen saturation, pulse rate, respiratory effort, sleep time and body position, doctors have several variables to work with.

“Our study provided clinical validation of a new wearable device for diagnosing sleep apnea,” said principal investigator Maria Merchant, Ph.D., CEO of Somnarus Inc. “It was most surprising to us how well this inexpensive miniature device performed in comparison with in-lab sleep studies.”

Another impressive aspect of the patch is how accessible it is for patients.174 who subjects participated in the American Academy of Sleep Medicine’s analysis. Using simultaneous polysomnography and patch recorders, they were able to discover signs of the disorder. Afterward, subjects took a home usability study, which determined that 38 of the 39 users successfully used the patch without any issues. Following the instructions, they were able to activate and collect a little more than 4 hours of sleep data.

“Most home sleep diagnostic devices are difficult for patients to use and are disruptive to patient’s sleep,” said Merchant. “Our study showed that this wearable home sleep monitor is very comfortable, easy to use and does not negatively affect sleep.”

Dr. Merchant explains that her team wants to put these positive results to good use. The researchers hope to present the patch and gain approval from the U.S. Food and Drug Administration.

Detecting Sleep Apnea

This technology is still in the process of approval. If you live with a family member or life partner, have them monitor your sleep. They should tell if you are snoring loudly, restless, or wake up unexpectedly during sleep. You should also pay attention to how your body feels during the day. A lack of energy, sleepiness, morning headaches, and other symptoms are telltale signs of the condition.

You should see a doctor immediately if you have any of these symptoms. See an otolaryngologist, who treats conditions that affect the ears, nose, and throat. They can perform certain procedures, like Functional Endoscopic Sinus Surgery and Balloon Sinuplasty, to improve your breathing and help you sleep better at night.

A young child aged around 3, 4 or 5 fast asleep, with untreated sleep apnea.

Untreated Sleep Apnea: The Harm to Your Child’s Brain Cells

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A young child aged around 3, 4 or 5 fast asleep, with untreated sleep apnea.

Untreated sleep apnea can lead to a decrease in brain function.

There are several key signs of sleep apnea that you should look for in your child. For example, snoring may seem like a common occurrence, but it is usually a sign of something obstructing the airways. You may also want to look out for recurring daytime sleepiness. Untreated sleep apnea can cause your child’s health to deteriorate over time. In fact, scientists have found that the disorder has the potential to harm a child’s brain cells if left unchecked.

Untreated Sleep Apnea and Developing Conditions

Conditions that affect your breathing often seem like a minor inconvenience rather than a pressing matter. However, the truth is that sleep disorders affect you over an extended period of time. The longer you wait to treat the problem, the worse your symptoms become. The disorder can even develop into chronic diseases. Some researchers have even associated untreated sleep apnea with diseases like diabetes, cardiovascular disease, obesity, and depression.

Brain Cells Affecting Mood and Cognition

At the University of Chicago Medical Center, scientists performed a study examining the sleep and brain patterns of children with and without severe sleep apnea, both ages 7 to 11 years old. The children stayed overnight at the university’s pediatric sleep laboratory while undergoing neuro-cognitive testing and MRI scans.

What they found was a significant difference between the two groups of kids. Those with moderate to severe sleep apnea had reductions in grey matter, a major part of the central nervous system. The children who slept with trouble showed no signs of reduced brain activity.

“The images of gray matter changes are striking,” said one of the study’s senior authors, Leila Kheirandish-Gozal, MD, director of pediatric clinical sleep research at the University of Chicago. “We do not yet have a precise guide to correlate loss of gray matter with specific cognitive deficits, but there is clear evidence of widespread neuronal damage or loss compared to the general population.”

Grey matter is brain cells that aid in a variety of essential functions. These functions include the brain’s ability to control movement, memory, emotions, speech, perception, decision-making and self-control. Grey matter is found in several regions of the brain including the frontal, prefrontal, and parietal cortices, as well as the temporal lobe and the brain stem.

Are Their Consequences to Lost Grey Matter

“MRI scans give us a bird’s eye view of the apnea-related difference in volume of various parts of the brain, but they don’t tell us, at the cellular level, what happened to the affected neurons or when,” said co-author David Gozal, MD, professor of pediatrics, University of Chicago. “The scans don’t have the resolution to determine whether brain cells have shrunk or been lost completely,” he added. “We can’t tell exactly when the damage occurred. But previous studies from our group showed that we can connect the severity of the disease with the extent of the cognitive deficits when such deficits are detectable.”

This study brings up a lot of questions. The scientists hope that more advanced brain scanning methods can help them measure if the lost grey matter has any effect on children. Future will determine definitive answers.

Gestational diabetes mellitus equipment, including an insulin pen and glucose level blood test.

Gestational Diabetes Mellitus: The Link to Pregnancy and Insufficient Sleep

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Gestational diabetes mellitus equipment, including an insulin pen and glucose level blood test.

Gestational diabetes mellitus is a serious problem within the Asian population.

According to the CDC, “Research has found that insufficient sleep is linked to an increased risk for the development of Type 2 diabetes.” For years, scientists have worked tirelessly to find out what that link is. New research is done every year, and every they become closer to finding the answer. In a recent study, scientists in Singapore have discovered the association between a lack of sleep during pregnancy and gestational diabetes mellitus (GDM).

Gestational Diabetes Mellitus (GDM) Among Asians

Unfortunately, Asians are at a higher risk of developing type 2 diabetes than people with European ancestry. Even worse, 60% percent of the world’s diabetic population are Asians and more than half of them go undiagnosed.

Singapore is especially a problem area. The country has the second-highest proportion of diabetes and one of the highest rates of gestational diabetes mellitus among developed nations. For this reason, scientists decided to conduct a study on the disease in this country.

GDM in Pregnancy

Gestational diabetes mellitus is a common problem among women who are pregnant. It can lead to pre-term labor, obstructed labor, birth trauma, high blood pressure for mothers, and increased risk of mother and fetal deaths. This is due to GDM causing high and unhealthy blood glucose levels.

In an extensive study that involved 686 women, Associate Professor Joshua Gooley from Duke-NUS Medical School (Duke-NUS) and Dr. Cai Shirong from the National University of Singapore Yong Loo Lin School of Medicine, were able to find answers. The women all took sleep questionnaires and had their glucose levels measured.

What they discovered was that women who received less than six hours of sleep were more likely to have GDM than those who received the standard eight recommended by the CDC. This proves that getting the necessary sleep you need lowers your risk of developing GDM and eventually Type 2 Diabetes. Hopefully, scientists can develop better methods to prevent this and reduce the disease among the Asian population.

An illustration of a pair of lungs affected by lung cancer.

Sleep Apnea: The Dangerous Aid to Lung Cancer?

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An illustration of a pair of lungs affected by lung cancer.

How does sleep apnea contribute to lung cancer cells? Find out why you should be wary of this disorder.

By now, most people know that cancer can affect almost any part of the body. Even worse, this disease affected at least 14.1 million people globally in 2012. With the severity of this disease, doctors and scientists are in a desperate search for any knowledge that might lead them to a cure.

One particular variation of cancer, lung cancer, is ranked 3rd among the CDC’s “2013 Top Ten Cancers” list. What potential factors affect this disease? According to a recent study, it might be sleep apnea.

Sleep Apnea and Lung Cancer

Now, this study doesn’t name sleep apnea as the cause of lung cancer. However, it suggests that the disorder helps the disease spread cancer cells. This happens because people do not receive enough oxygen during sleep, causing hypoxia.

Hypoxia is a condition that occurs when the bodies tissues do not receive the right amount of oxygen. In some cases, hypoxia can cause nausea, lightheadedness, hallucinations, severe headaches, tachycardia, and pulmonary hypertension. That lack of oxygen also holds the potential to increase the growth of tumors.

The scientists came to this conclusion by testing two groups of mice with lung cancer tumors. One group experience normal breathing patterns. On the other hand, the other group experienced sleep apnea through the introduction of intermittent hypoxia, which is a therapy used to induced hypoxia. With these two groups, the scientists were able to see if sleep apnea truly affected lung cancer cells.

Hypoxia and sleep apnea appear to release exosomes, cell-derived vesicles which promote cell growth. Normally, these vesicles would be a good thing, as they also move proteins, lipids, mRNAs, and miRNAs from cell to cell.

However, lead investigator of the study, David Gozal, states “Hypoxia can increase exosomal release and selectively modify exosome contents such as to enhance tumor proliferation and angiogenesis. We found the overall concentrations of plasma-isolated exosomes in IH-exposed mice were significantly increased.”

Researchers are interested in exosomes and their greater role in cancer. This study only brings up more questions in the fight against cancer, but it does answer one. It shows that sleep apnea plays a part in making lung cancer worse.

A man is sleeping in bed. He is wearing one of many CPAP machines given to patients with sleep apnea.

CPAP Machines Ineffective at Treating Heart Risk

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A man is sleeping in bed. He is wearing one of many CPAP machines given to patients with sleep apnea.

Researchers call into question whether or not CPAP machines are effective at fighting heart conditions. 

Continuous positive airway pressure machines, or CPAP machines, are devices designed to help sleep apnea patients. It is effective at combating the symptoms of those with breathing problems or sleep apnea.

Since sleep apnea is a condition that can lead to other disorders, many scientists believe that CPAP treatments would be effective against them. However, a new study suggest that CPAP machines do not help to alleviate heart risk in those with sleep apnea.

CPAP Machines and Heart Risk

For years, scientists have noticed that there is a connection between sleep apnea and cardiovascular disease – particularly in men.  According to the National Sleep Foundation, men with severe obstructive sleep apnea (OSA) are 58% more likely to develop congestive heart failure than men without sleep apnea. Some studies in the past have suggest that patients who regularly underwent CPAP treatments were less likely to experience instances of a stroke or heart attack.

A recent study called the Sleep Apnea Cardiovascular Endpoints (SAVE) study, which is managed by the Adelaide Institute for Sleep Health of Flinders University of South Australia, determined that CPAP machines is not as effective at reducing heart risk as scientists have believed. This multicenter study tested 2,717 patients from 89 medical centers in seven countries. The patients had moderate to severe OSA, coronary artery or cerebrovascular disease and most of them were older males with a snoring issue.

In order to test how the CPAP machines affected their heart conditions, the researcher separated the patients. One group was required to practice healthy sleeping habits, while the other was required the same plus CPAP therapy. The second group was required to use the machines at least 3 hours per night.

The study lasted 1 week and what researchers found was that patients using CPAP machines did not show any improvements over those who did not. However, the machines are still successful against sleep apnea. More research need to be done to truly determine if CPAP cannot help those with sleep apnea related heart risk.

A doctor making notes about a patient with stroke risk.

Sleep Disorders Increase Stroke Risk

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A doctor making notes about a patient with stroke risk.

Stroke risk increases as patients ignore their sleep apnea symptoms.

As sleep disorders become more and more prevalent, so does the risk from not treating them. It’s important to have these disorders diagnosed; otherwise it will evolve into something much worse. In a new study by the American Academy of Neurology, their research suggests that sleep disorders, like insomnia and oversleeping, may increase stroke risk.

Patients and Stroke Risk

A stroke is essentially an attack within the brain that happens when blood vessels are blocked or the brain starts to bleed. It can cause weakness, dizziness, slurred speech, vision problem and numbness. According to the Center for Disease Control (CDC), more than 800,000 people in the United States have a stroke each year, and on average, one American dies every 4 minutes from a stroke.

Disorders, like insomnia and oversleeping, are common among patients who have suffered from a stroke. However, research shows that they also can act as a telling sign. According to Dirk M. Hermann, MD, of the University Hospital Essen, and study author, “People with sleep disorders may be more likely to have another stroke or other negative outcomes than people without sleep problems, such as having to go to a nursing home after leaving the hospital.”

This study stresses the importance of getting tested. Without testing, patients are left undiagnosed and untreated for their sleeping disorders. The negative outcomes of insomnia include depression, daytime sleepiness, fatigue, and irritability. Oversleeping has been known to cause diabetes, obesity, and headaches.

The most common treatment for sleep disorder is a continuous positive airway pressure machine (CPAP). This treatment has proven itself success for resolving sleep disorder. The researchers also note that stroke risk in patients with sleep disorder decreased after receiving this treatment.

Stroke risk certainly increases the longer one waits to be treated. The researchers hope that the study will make more patients aware of the issue.

A graphic image of fatty liver disease.

Sleep Apnea and Liver Disease: Obese Adolescents at Risk

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A graphic image of fatty liver disease.

As sleep apnea goes untreated, people are at risk for non-alcoholic liver disease.

Sleep disorders like sleep apnea are dangerous if left untreated. New studies suggest that the risks to those who develop the disorder are becoming greater and greater every day. One such study, reported in the “Journal of Hepatology,” suggests that obstructive sleep apnea (OSA) contributes a great deal to non-alcoholic fatty liver disease (NAFLD) in adults and children.

What Is NAFLD?

Non-alcoholic fatty liver disease (NAFLD) is a condition where fat builds up in the liver. This may be due to a resistance to insulin and a metabolic syndrome. This disorder usually shows up in a high percentage of those with obesity.  This is a liver disease that is not caused by alcohol, hence the name.

It is unhealthy to have too much fat stored in the liver. This causes the liver to swell up, scarring is developed, and can lead to liver cancer or failure. There aren’t that many symptoms with NAFLD. Typically the disorder causes the following:

  • Fatigue
  • Malaise
  • Spider-like blood vessels
  • Jaundice
  • Edema
  • Ascites (abdominal swelling)
  • Abdominal discomfort.

How Sleep Apnea Causes Liver Disease

Due to low levels of oxygen during sleep, many patients with sleep apnea develop oxidative stress, which means that their body has trouble detoxifying the harmful effects of free radicals. This can speed up the progression of NAFLD, and eventually lead to a worst disease called non-alcoholic steatohepatitis (NASH).

Lead investigator Shikha Sundaram, MD, MSCI, of the Children’s Hospital Colorado, University of Colorado School of Medicine stated, “According to recent reports, pediatric NAFLD patients with OSA/hypoxia have more advanced liver disease and fibrosis, supporting a role for OSA/hypoxia in the development of NASH. However, the mechanisms underlying this relationship have not yet been explained.”

The disease affects 30% of the general population in Western countries, and about 9.6% of all children. With the growing issue of obesity, this condition could potentially affect more people every year.

The researcher’s findings showed that patients with severe liver disease also had a serious case of OSA. They hope that correlation between the two conditions will lead to finding a way to treat patients. “We definitely need trials designed to investigate whether CPAP treatment may significantly affect NAFLD progression in this age range. The only randomized controlled trial was of relatively short duration, performed on adult patients with mild OSA/hypoxia and normal baseline transaminases, and apparently did not demonstrate any impact on steatosis, NASH or liver fibrosis,” says Dr. Sundaram.

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