Trial reportThe Journal of clinical endocrinology and metabolism2017
Obstructive Sleep Apnea Dynamically Increases Nocturnal Plasma Free Fatty Acids, Glucose, and Cortisol During Sleep.
Trial report in The Journal of clinical endocrinology and metabolism, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
75 citing papers in PubMed, 3 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Interleukin-8 concentrations in obstructive sleep apnea syndrome: a systematic review and meta-analysis.Bioengineered · 2021Pooled it
- Individual differences in glucocorticoid regulation: Does it relate to disease risk and resilience?Frontiers in neuroendocrinology · 2020Pooled it
- Associations of variants In the hexokinase 1 and interleukin 18 receptor regions with oxyhemoglobin saturation during sleep.PLoS genetics · 2019Pooled it
- Propranolol mitigates sleep apnea-related cardiac responses during CPAP withdrawal: a randomized placebo-controlled cross-over clinical study.Sleep & breathing = Schlaf & Atmung · 2026Trial
- Intermittent hypoxia increases lipid insulin resistance in healthy humans: A randomized crossover trial.Journal of sleep research · 2025Trial
- The effect of acute intermittent hypoxia on postprandial triglyceride levels in humans: a randomized crossover trial.Journal of translational medicine · 2021Trial
- Sleep-disordered breathing, circulating exosomes, and insulin sensitivity in adipocytes.International journal of obesity (2005) · 2018Trial
- Plasma β-hydroxybutyrate concentrations in young adult females after a high-fat meal under normoxaemia, intermittent hypoxaemia and continuous hypoxaemia: An exploratory analysis.Experimental physiology · 2026Article
- Mechanisms underlying end-organ injury in sleep apnoea.The European respiratory journal · 2026Review
- Article
- Exploring the cardiometabolic profile of Emirati adults at risk for obstructive sleep apnea: findings from the UAE healthy future study.Frontiers in sleep · 2026Article
- Clinical and psychosocial variables influencing preoperative anxiety in patients undergoing sinus surgery.American journal of translational research · 2026Article
- Endocrinology and the Lung: Exploring the Bidirectional Axis and Future Directions.Journal of clinical medicine · 2025Article
- Exploring the Causal Effect of Mitochondrial DNA Copy Number on Obstructive Sleep Apnea.Brain and behavior · 2025Article
- Development of the scale on the effects of sleep disorder on stress: validity and reliability study.BMC psychiatry · 2025Article
- Sleep duration and cardiovascular disease risk in type 2 diabetes: A prospective cohort study.PloS one · 2025Article
- Burdened breaths: The influence of depression on obstructive sleep apnea.World journal of psychiatry · 2024Article
- Article
- Recent progresses in gut microbiome mediates obstructive sleep apnea-induced cardiovascular diseases.FASEB bioAdvances · 2024Review
- Association of Obstructive Sleep Apnea with Nonalcoholic Fatty Liver Disease: Evidence, Mechanism, and Treatment.Nature and science of sleep · 2024Review
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
Context: Obstructive sleep apnea (OSA) is associated with diabetes and cardiovascular disease. This association may be related to metabolic changes that transpire during sleep in OSA. Objective: To examine the impact of OSA, elicited by cessation of continuous positive airway pressure (CPAP), on frequently sampled nocturnal metabolic markers including plasma free fatty acids (FFAs), glucose, insulin, triglycerides (TGs), cortisol, and lactate, as well as glucose production, oral glucose tolerance, blood pressure (BP), endothelial function, cholesterol, and high-sensitivity C-reactive protein (hsCRP). Design and Setting: Randomized crossover trial of CPAP vs CPAP withdrawal. Patients: Thirty-one patients with moderate to severe OSA acclimated to CPAP. Intervention: Patients underwent attended polysomnography while sleeping with therapeutic CPAP, or after CPAP withdrawal, in random order. Venous blood was sampled at ∼20-minute intervals on both nights. In 11 patients, we assessed glucose kinetics with an infusion of 6,6-[2H2]glucose. Results: CPAP withdrawal caused recurrence of OSA associated with hypoxemia, sleep disruption, and heart rate (HR) elevation. CPAP withdrawal dynamically increased nocturnal FFA (P = 0.007), glucose (P = 0.028), and cortisol (P = 0.037), in proportion to respiratory event frequency, HR elevation, or sleep fragmentation. Diabetes predisposed to glucose elevation. CPAP withdrawal also increased systolic BP (P = 0.017) and augmentation index (P = 0.008), but did not affect insulin, TGs, glucose production, oral glucose tolerance, cholesterol, or hsCRP. Conclusion: OSA recurrence during CPAP withdrawal increases FFA and glucose during sleep, associated with sympathetic and adrenocortical activation. Recurring exposure to these metabolic changes may foster diabetes and cardiovascular disease.
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Registered trials
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 OpenQuestion graph.