Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy
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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2018-03-01
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| Series: | Journal of Metabolic Health |
| Subjects: | |
| Online Access: | https://journalofmetabolichealth.org/index.php/jmh/article/view/34 |
| _version_ | 1797246572241616896 |
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| author | Catherine A.P. Crofts Alister Neill Angela Campbell Jim Bartley David E. White |
| author_facet | Catherine A.P. Crofts Alister Neill Angela Campbell Jim Bartley David E. White |
| author_sort | Catherine A.P. Crofts |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-24T19:44:56Z |
| format | Article |
| id | doaj.art-2300f1f0b4ad4a9f9d2909a63ce6adce |
| institution | Directory Open Access Journal |
| issn | 2960-0391 |
| language | English |
| last_indexed | 2024-04-24T19:44:56Z |
| publishDate | 2018-03-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of Metabolic Health |
| spelling | doaj.art-2300f1f0b4ad4a9f9d2909a63ce6adce2024-03-25T07:51:23ZengAOSISJournal of Metabolic Health2960-03912018-03-0131e1e610.4102/jir.v3i1.3416Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapyCatherine A.P. Crofts0Alister Neill1Angela Campbell2Jim Bartley3David E. White4Faculty of Health and Environmental Sciences, Auckland University of TechnologyWellSleep Clinic, University of OtagoWellSleep Clinic, University of OtagoDepartment of Surgery, University of OtagoBioDesign Lab, Auckland University of TechnologyBackground: 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.https://journalofmetabolichealth.org/index.php/jmh/article/view/34sleep apnoeametabolic diseasesympathovagal balancesleep architecturehyperinsulinaemia |
| spellingShingle | Catherine A.P. Crofts Alister Neill Angela Campbell Jim Bartley David E. White Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy Journal of Metabolic Health sleep apnoea metabolic disease sympathovagal balance sleep architecture hyperinsulinaemia |
| title | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy |
| title_full | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy |
| title_fullStr | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy |
| title_full_unstemmed | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy |
| title_short | Sleep architecture, insulin resistance and the nasal cycle: Implications for positive airway pressure therapy |
| title_sort | sleep architecture insulin resistance and the nasal cycle implications for positive airway pressure therapy |
| topic | sleep apnoea metabolic disease sympathovagal balance sleep architecture hyperinsulinaemia |
| url | https://journalofmetabolichealth.org/index.php/jmh/article/view/34 |
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