TOPLINE: 

Patients with type 2 diabetes (T2D) and obstructive sleep apnea (OSA) who were prescribed continuous positive airway pressure (CPAP) had a 26% lower risk for mortality than patients with T2D not prescribed CPAP in an observational study.

METHODOLOGY: 

• OSA significantly affects cardiovascular risk and mortality, yet it often remains undiagnosed in patients with T2D.
• Researchers analyzed data from five Swedish national registers, including 12,388 patients with T2D and OSA who were prescribed CPAP and 737,911 patients with T2D without CPAP prescriptions whose OSA status was unknown.
• The primary outcome was all-cause mortality, assessed using a time-varying Cox regression model adjusted for baseline differences and factors such as BMI, smoking, and blood pressure.

TAKEAWAY:

• The CPAP group was younger than the non-CPAP group (mean age, 58 vs 65 years) and had a higher mean BMI (34.7 vs 30.6).
• Overall, 764 deaths occurred in the CPAP group (6%) and 212,336 in the non-CPAP group (29%) over 14 years of follow-up.
• Treatment with CPAP was linked to a reduced risk for mortality in patients with T2D and OSA (adjusted hazard ratio, 0.74; 95% CI, 0.68-0.82, P > .001).

IN PRACTICE:

"Despite the substantial impact of obstructive sleep apnoea on cardiovascular disease and survival, it often goes undiagnosed in people with type 2 diabetes and is not routinely addressed as part of diabetes management," said lead author Jonas Agholme, MD, in a press release. "The findings suggest that CPAP may play an important role in improving patient outcomes and survival, and they underline the value of early OSA diagnosis in people with T2D," he added.

SOURCE: 

The study was led by Jonas Agholme, MD, Linköping University, Sweden. It will be presented at the European Association for the Study of Diabetes 2025 Annual Meeting in Vienna, September 15-19, 2025.

LIMITATIONS: 

The study was observational in nature, and residual confounding and selection bias could not be ruled out. Data on adherence to CPAP treatment were available only for a small subset of patients, and information on the severity of sleep apnea across groups was lacking. The study was conducted within the Swedish healthcare system, which may have limited the generalizability of the findings.

DISCLOSURES:

One author reported receiving grants, another author reported receiving unrestricted grants from Wallenberg Center for Molecular Medicine.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.