Potential Use of SGLT-2 Inhibitors in Obstructive Sleep Apnea: A new treatment on the horizon.
Continuous positive airway pressure
Diabetes mellitus
Obstructive sleep apnea
Sodium-glucose cotransporter-2
Journal
Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Titre abrégé: Sleep Breath
Pays: Germany
ID NLM: 9804161
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
03
01
2022
accepted:
22
03
2022
revised:
20
02
2022
pubmed:
6
4
2022
medline:
10
3
2023
entrez:
5
4
2022
Statut:
ppublish
Résumé
Obstructive sleep apnea (OSA) is characterized by hypoxic episodes due to collapse of the airway during sleep and is frequently associated with obesity, type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). There is currently no pharmacological agent approved for the treatment of OSA. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have the potential to both increase life expectancy and quality of life of these patients making them promising agents for this role. There are relatively few studies investigating this possible beneficial relationship between these drugs and OSA. We aimed to increase awareness on the potential benefits of SGLT2 inhibitors in OSA patients by describing the current evidence on the effectiveness of these inhibitors in both overall and cardiovascular morbidity and mortality. We performed a literature search for articles reporting on the use of SGLT2 inhibitors in patients with OSA and T2DM. We identified 4 manuscripts studying the use of SGLT2 inhibitors in 475 OSA patients with T2DM. Among them, 332 patients were administered SGLT2 inhibitors, and 143 patients were in a control group. SGLT2 inhibitors have many potential positive impacts on OSA patients by targeting various mechanisms involved in OSA pathogenesis. SGLT2 inhibitors are prime pharmacological candidates for the treatment of OSA, and additional studies are needed to better explore mechanisms and outcomes unique to this population. Additionally, patients with OSA often have multiple comorbidities that are clinical indications for SGLT2 inhibitor therapy. Physicians should recognize and encourage the use of these agents in such patients.
Sections du résumé
BACKGROUND
Obstructive sleep apnea (OSA) is characterized by hypoxic episodes due to collapse of the airway during sleep and is frequently associated with obesity, type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). There is currently no pharmacological agent approved for the treatment of OSA. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have the potential to both increase life expectancy and quality of life of these patients making them promising agents for this role. There are relatively few studies investigating this possible beneficial relationship between these drugs and OSA.
METHOD
We aimed to increase awareness on the potential benefits of SGLT2 inhibitors in OSA patients by describing the current evidence on the effectiveness of these inhibitors in both overall and cardiovascular morbidity and mortality. We performed a literature search for articles reporting on the use of SGLT2 inhibitors in patients with OSA and T2DM.
RESULTS
We identified 4 manuscripts studying the use of SGLT2 inhibitors in 475 OSA patients with T2DM. Among them, 332 patients were administered SGLT2 inhibitors, and 143 patients were in a control group. SGLT2 inhibitors have many potential positive impacts on OSA patients by targeting various mechanisms involved in OSA pathogenesis.
CONCLUSION
SGLT2 inhibitors are prime pharmacological candidates for the treatment of OSA, and additional studies are needed to better explore mechanisms and outcomes unique to this population. Additionally, patients with OSA often have multiple comorbidities that are clinical indications for SGLT2 inhibitor therapy. Physicians should recognize and encourage the use of these agents in such patients.
Identifiants
pubmed: 35378662
doi: 10.1007/s11325-022-02606-1
pii: 10.1007/s11325-022-02606-1
doi:
Substances chimiques
Sodium-Glucose Transporter 2 Inhibitors
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
77-89Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Babu AR, Herdegen J, Fogelfeld L, Shott S, Mazzone T (2005) Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med 165(4):447–452
pubmed: 15738376
doi: 10.1001/archinte.165.4.447
Ozkok A, Kanbay A, Odabas AR, Covic A, Kanbay M (2014) Obstructive sleep apnea syndrome and chronic kidney disease: a new cardiorenal risk factor. Clin Exp Hypertens 36(4):211–216
pubmed: 24432915
doi: 10.3109/10641963.2013.804546
Mehta V, Subramanyam R, Shapiro CM, Chung F (2012) Health effects of identifying patients with undiagnosed obstructive sleep apnea in the preoperative clinic: a follow-up study. Can J Anaesth 59(6):544–555
pubmed: 22461134
pmcid: 3345111
doi: 10.1007/s12630-012-9694-8
Aslan G, Afsar B, Siriopol D, Kanbay A, Sal O, Benli C et al (2018) Cardiovascular Effects of Continuous Positive Airway Pressure Treatment in Patients With Obstructive Sleep Apnea: A Meta-Analysis. Angiology 69(3):195–204
pubmed: 28506075
doi: 10.1177/0003319717709175
Gottlieb DJ, Punjabi NM (2020) Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA 323(14):1389–1400
pubmed: 32286648
doi: 10.1001/jama.2020.3514
Cherney DZ, Kanbay M, Lovshin JA (2020) Renal physiology of glucose handling and therapeutic implications. Nephrol Dial Transplant 35(Suppl 1):i3–i12
pubmed: 32003835
pmcid: 6993194
doi: 10.1093/ndt/gfz230
Fernandez-Fernandez B, Sarafidis P, Kanbay M, Navarro-Gonzalez JF, Soler MJ, Gorriz JL et al (2020) SGLT2 inhibitors for non-diabetic kidney disease: drugs to treat CKD that also improve glycaemia. Clin Kidney J 13(5):728–733
pubmed: 33123352
pmcid: 7577767
doi: 10.1093/ckj/sfaa198
Zelniker TA, Wiviott SD, Raz I, Im K, Goodrich EL, Bonaca MP et al (2019) SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet 393(10166):31–39
pubmed: 30424892
doi: 10.1016/S0140-6736(18)32590-X
Osman AM, Carter SG, Carberry JC, Eckert DJ (2018) Obstructive sleep apnea: current perspectives. Nat Sci Sleep 10:21–34
pubmed: 29416383
pmcid: 5789079
doi: 10.2147/NSS.S124657
Greenberg H, Ye X, Wilson D, Htoo AK, Hendersen T, Liu SF (2006) Chronic intermittent hypoxia activates nuclear factor-kappaB in cardiovascular tissues in vivo. Biochem Biophys Res Commun 343(2):591–596
pubmed: 16554025
doi: 10.1016/j.bbrc.2006.03.015
Fletcher EC, Lesske J, Behm R, Miller CC, Stauss H, Unger T. Carotid chemoreceptors, systemic blood pressure, and chronic episodic hypoxia mimicking sleep apnea. J Appl Physiol (1985). 1992;72(5):1978–84.
Phillips SA, Olson EB, Lombard JH, Morgan BJ. Chronic intermittent hypoxia alters NE reactivity and mechanics of skeletal muscle resistance arteries. J Appl Physiol (1985). 2006;100(4):1117–23.
Polotsky VY, Li J, Punjabi NM, Rubin AE, Smith PL, Schwartz AR et al (2003) Intermittent hypoxia increases insulin resistance in genetically obese mice. J Physiol 552(Pt 1):253–264
pubmed: 12878760
pmcid: 2343324
doi: 10.1113/jphysiol.2003.048173
Ashrafian H, Toma T, Rowland SP, Harling L, Tan A, Efthimiou E et al (2015) Bariatric Surgery or Non-Surgical Weight Loss for Obstructive Sleep Apnoea? A Systematic Review and Comparison of Meta-analyses. Obes Surg 25(7):1239–1250
pubmed: 25537297
doi: 10.1007/s11695-014-1533-2
Hudgel DW, Patel SR, Ahasic AM, Bartlett SJ, Bessesen DH, Coaker MA et al (2018) The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 198(6):e70–e87
pubmed: 30215551
doi: 10.1164/rccm.201807-1326ST
Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG (2019) Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 15(2):335–343
pubmed: 30736887
pmcid: 6374094
doi: 10.5664/jcsm.7640
Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P et al (2013) Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med 159(7):471–483
pubmed: 24061345
Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H et al (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30(6):711–719
pubmed: 17580592
pmcid: 1978355
doi: 10.1093/sleep/30.6.711
Martinez-Garcia MA, Capote F, Campos-Rodriguez F, Lloberes P, Diaz de Atauri MJ, Somoza M, et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial. JAMA. 2013;310(22):2407–15.
Gaisl T, Haile SR, Thiel S, Osswald M, Kohler M (2019) Efficacy of pharmacotherapy for OSA in adults: A systematic review and network meta-analysis. Sleep Med Rev 46:74–86
pubmed: 31075665
doi: 10.1016/j.smrv.2019.04.009
Cherney DZKM, Lovshin JA (2020) Renal physiology of glucose handling and therapeutic implications. Nephrol Dial Transplant 35:i3–i12
pubmed: 32003835
pmcid: 6993194
doi: 10.1093/ndt/gfz230
Fernandez-Fernandez BSP, Kanbay M, Navarro-González JF, Soler MJ, Górriz JL (2020) Ortiz A SGLT2 inhibitors for non-diabetic kidney disease: drugs to treat CKD that also improve glycaemia. Clin Kidney J 13(5):728–733
pubmed: 33123352
pmcid: 7577767
doi: 10.1093/ckj/sfaa198
Cherney DZI, Dagogo-Jack S, McGuire DK, Cosentino F, Pratley R, Shih WJ et al (2021) Kidney outcomes using a sustained >/=40% decline in eGFR: A meta-analysis of SGLT2 inhibitor trials. Clin Cardiol 44(8):1139–1143
pubmed: 34129237
pmcid: 8364727
doi: 10.1002/clc.23665
Liu H, Sridhar VS, Boulet J, Dharia A, Khan A, Lawler PR et al (2022) Cardiorenal protection with SGLT2 inhibitors in patients with diabetes mellitus: from biomarkers to clinical outcomes in heart failure and diabetic kidney disease. Metabolism. 126:154918
pubmed: 34699838
doi: 10.1016/j.metabol.2021.154918
Lawler PR, Liu H, Frankfurter C, Lovblom LE, Lytvyn Y, Burger D et al (2021) Changes in Cardiovascular Biomarkers Associated With the Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Ertugliflozin in Patients With Chronic Kidney Disease and Type 2 Diabetes. Diabetes Care 44(3):e45–e47
pubmed: 33436398
doi: 10.2337/dc20-2265
Joshi SS, Singh T, Newby DE, Singh J (2021) Sodium-glucose co-transporter 2 inhibitor therapy: mechanisms of action in heart failure. Heart (British Cardiac Society) 107(13):1032–1038
pubmed: 33637556
Pinto LCRD, Remonti LR, Kramer CK, Leitao CB, Gross JL (2015) Efficacy of SGLT2 inhibitors in glycemic control, weight loss and blood pressure reduction: a systematic review and meta-analysis. Diabetol Metab Syndr 7:A58
pmcid: 4653505
doi: 10.1186/1758-5996-7-S1-A58
Ramirez-Rodriguez AM, Gonzalez-Ortiz M, Martinez-Abundis E (2020) Effect of Dapagliflozin on Insulin Secretion and Insulin Sensitivity in Patients with Prediabetes. Exp Clin Endocrinol Diabetes 128(8):506–511
pubmed: 30149417
doi: 10.1055/a-0664-7583
Gunhan HG, Imre E, Erel P, Ustay O (2020) Empagliflozin Is More Effective in Reducing Microalbuminuria and Alt Levels Compared with Dapagliflozin: Real Life Experience. Acta Endocrinol (Buchar) 16(1):59–67
pubmed: 32685040
pmcid: 7364004
doi: 10.4183/aeb.2020.59
LambersHeerspink HJ, de Zeeuw D, Wie L, Leslie B, List J (2013) Dapagliflozin a glucose-regulating drug with diuretic properties in subjects with type 2 diabetes. Diabetes Obes Metab 15(9):853–862
doi: 10.1111/dom.12127
Cherney DZ, Perkins BA, Soleymanlou N, Har R, Fagan N, Johansen OE et al (2014) The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus. Cardiovasc Diabetol 13:28
pubmed: 24475922
pmcid: 3915232
doi: 10.1186/1475-2840-13-28
Majewski C, Bakris GL (2015) Blood pressure reduction: an added benefit of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes. Diabetes Care 38(3):429–430
pubmed: 25715414
pmcid: 4876696
doi: 10.2337/dc14-1596
Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S et al (2015) Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 373(22):2117–2128
pubmed: 26378978
doi: 10.1056/NEJMoa1504720
Edwards JL (2016) Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 374(11):1093
pubmed: 26981943
Sarafidis PA, Tsapas A (2016) Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 374(11):1092
pubmed: 26981941
doi: 10.1056/NEJMc1600827
Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A et al (2019) Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 380(4):347–357
pubmed: 30415602
doi: 10.1056/NEJMoa1812389
Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Nieto FJ et al (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25
pubmed: 11208620
doi: 10.1164/ajrccm.163.1.2001008
McGuire DK, Shih WJ, Cosentino F, Charbonnel B, Cherney DZI, Dagogo-Jack S et al (2021) Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes: A Meta-analysis. JAMA Cardiol 6(2):148–158
pubmed: 33031522
doi: 10.1001/jamacardio.2020.4511
Mir T, Bin Atique H, Regmi N, Sattar Y, Sundus S, Ambreen S et al (2021) SGLT2 inhibitors and sleep apnea; how helpful are the medications: a meta-analysis. Endocr Metab Sci 2:100084
doi: 10.1016/j.endmts.2021.100084
Rotenberg BW, Murariu D, Pang KP (2016) Trends in CPAP adherence over twenty years of data collection: a flattened curve. J Otolaryngol Head Neck Surg 45(1):43
pubmed: 27542595
pmcid: 4992257
doi: 10.1186/s40463-016-0156-0
Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053
pubmed: 15781100
doi: 10.1016/S0140-6736(05)71141-7
McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X et al (2016) CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 375(10):919–931
pubmed: 27571048
doi: 10.1056/NEJMoa1606599
Wang H, Parker JD, Newton GE, Floras JS, Mak S, Chiu KL et al (2007) Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 49(15):1625–1631
pubmed: 17433953
doi: 10.1016/j.jacc.2006.12.046
Labarca G, Reyes T, Jorquera J, Dreyse J, Drake L (2018) CPAP in patients with obstructive sleep apnea and type 2 diabetes mellitus: Systematic review and meta-analysis. Clin Respir J 12(8):2361–2368
pubmed: 30073792
doi: 10.1111/crj.12915
Xu PH, Hui CKM, Lui MMS, Lam DCL, Fong DYT, Ip MSM (2019) Incident Type 2 Diabetes in OSA and Effect of CPAP Treatment: A Retrospective Clinic Cohort Study. Chest 156(4):743–753
pubmed: 31128116
doi: 10.1016/j.chest.2019.04.130
Nena E, Steiropoulos P, Tzouvelekis A, Tsara V, Hatzizisi O, Kyriazis G et al (2010) Reduction of serum retinol-binding protein-4 levels in nondiabetic obstructive sleep apnea patients under continuous positive airway pressure treatment. Respiration 80(6):517–523
pubmed: 20224248
doi: 10.1159/000295903
Steiropoulos P, Papanas N, Nena E, Tsara V, Fitili C, Tzouvelekis A et al (2009) Markers of glycemic control and insulin resistance in non-diabetic patients with Obstructive Sleep Apnea Hypopnea Syndrome: does adherence to CPAP treatment improve glycemic control? Sleep Med 10(8):887–891
pubmed: 19231280
doi: 10.1016/j.sleep.2008.10.004
Drager LF, Brunoni AR, Jenner R, Lorenzi-Filho G, Benseñor IM, Lotufo PA (2015) Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials. Thorax 70(3):258–264
pubmed: 25432944
doi: 10.1136/thoraxjnl-2014-205361
Gonzaga C, Bertolami A, Bertolami M, Amodeo C, Calhoun D (2015) Obstructive sleep apnea, hypertension and cardiovascular diseases. J Hum Hypertens 29(12):705–712
pubmed: 25761667
doi: 10.1038/jhh.2015.15
Thavaraputta S, Dennis JA, Laoveeravat P, Nugent K, Rivas AM (2019) Hypothyroidism and Its Association With Sleep Apnea Among Adults in the United States: NHANES 2007–2008. J Clin Endocrinol Metab 104(11):4990–4997
pubmed: 31305928
doi: 10.1210/jc.2019-01132
Neeland IJEB, Kasai T, Marx N, Zinman B, Inzucchi SE, Wanner C, Zwiener I, Wojeck BS, Yaggi HK, Johansen OE (2020) The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial. Diabetes Care 43(12):3007–3015
pubmed: 33004464
pmcid: 7770278
doi: 10.2337/dc20-1096
Sato T, Aizawa Y, Yuasa S, Kishi S, Fuse K, Fujita S et al (2018) The effect of dapagliflozin treatment on epicardial adipose tissue volume. Cardiovasc Diabetol 17(1):6
pubmed: 29301516
pmcid: 5753537
doi: 10.1186/s12933-017-0658-8
Shabaka A, Cases-Corona C, Fernandez-Juarez G (2021) Therapeutic Insights in Chronic Kidney Disease Progression. Front Med (Lausanne). 8:645187
pubmed: 33708784
pmcid: 7940523
doi: 10.3389/fmed.2021.645187
Furukawa S, Miyake T, Senba H, Sakai T, Furukawa E, Yamamoto S et al (2018) The effectiveness of dapagliflozin for sleep-disordered breathing among Japanese patients with obesity and type 2 diabetes mellitus. Endocr J 65(9):953–961
pubmed: 30047511
doi: 10.1507/endocrj.EJ17-0545
Sawada K, Karashima S, Kometani M, Oka R, Takeda Y, Sawamura T et al (2018) Effect of sodium glucose cotransporter 2 inhibitors on obstructive sleep apnea in patients with type 2 diabetes. Endocr J 65(4):461–467
pubmed: 29459554
doi: 10.1507/endocrj.EJ17-0440
Revol B, Jullian-Desayes I, Bailly S, Tamisier R, Grillet Y, Sapène M et al (2020) Who May Benefit From Diuretics in OSA?: A Propensity Score-Match Observational Study. Chest 158(1):359–364
pubmed: 32119859
doi: 10.1016/j.chest.2020.01.050
Sica DA, Carter B, Cushman W, Hamm L (2011) Thiazide and loop diuretics. J Clin Hypertens (Greenwich) 13(9):639–643
pubmed: 21896142
doi: 10.1111/j.1751-7176.2011.00512.x
Agarwal R, Sinha AD, Cramer AE, Balmes-Fenwick M, Dickinson JH, Ouyang F et al (2021) Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease. N Engl J Med 385(27):2507–2519
pubmed: 34739197
pmcid: 9119310
doi: 10.1056/NEJMoa2110730
Santos-Gallego CG, Requena-Ibanez JA, San Antonio R, Ishikawa K, Watanabe S, Picatoste B et al (2019) Empagliflozin Ameliorates Adverse Left Ventricular Remodeling in Nondiabetic Heart Failure by Enhancing Myocardial Energetics. J Am Coll Cardiol 73(15):1931–1944
pubmed: 30999996
doi: 10.1016/j.jacc.2019.01.056
Parati G, Lombardi C, Hedner J, Bonsignore MR, Grote L, Tkacova R et al (2013) Recommendations for the management of patients with obstructive sleep apnoea and hypertension. Eur Respir J 41(3):523–538
pubmed: 23397300
doi: 10.1183/09031936.00226711
Cuspidi C, Tadic M, Sala C, Gherbesi E, Grassi G, Mancia G (2019) Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis. J Clin Med; 8(9).
Mohammad Y, Almutlaq A, Al-Ruwaita A, Aldrees A, Alsubaie A, Al-Hussain F (2019) Stroke during sleep and obstructive sleep apnea: there is a link. Neurol Sci 40(5):1001–1005
pubmed: 30758735
doi: 10.1007/s10072-019-03753-2
Dai S, Huang B, Zou Y, Liu Y (2019) Associations of dipping and non-dipping hypertension with cardiovascular diseases in patients with dyslipidemia. Arch Med Sci 15(2):337–342
pubmed: 30899285
doi: 10.5114/aoms.2018.72609
Lempiainen PA, Vasunta RL, Bloigu R, Kesaniemi YA, Ukkola OH (2019) Non-dipping blood pressure pattern and new-onset diabetes in a 21-year follow-up. Blood Press 28(5):300–308
pubmed: 31092019
doi: 10.1080/08037051.2019.1615369
Tang Y, Sun Q, Bai XY, Zhou YF, Zhou QL, Zhang M (2019) Effect of dapagliflozin on obstructive sleep apnea in patients with type 2 diabetes: a preliminary study. Nutr Diabetes 9(1):32
pubmed: 31685792
pmcid: 6828696
doi: 10.1038/s41387-019-0098-5
Brown E, Wilding JPH, Barber TM, Alam U, Cuthbertson DJ (2019) Weight loss variability with SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes mellitus and obesity: Mechanistic possibilities. Obes Rev 20(6):816–828
pubmed: 30972878
doi: 10.1111/obr.12841
Redolfi S, Yumino D, Ruttanaumpawan P, Yau B, Su MC, Lam J et al (2009) Relationship between overnight rostral fluid shift and Obstructive Sleep Apnea in nonobese men. Am J Respir Crit Care Med 179(3):241–246
pubmed: 19011149
doi: 10.1164/rccm.200807-1076OC
Neeland IJ, Eliasson B, Kasai T, Marx N, Zinman B, Inzucchi SE et al (2020) The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial. Diabetes Care 43(12):3007–3015
pubmed: 33004464
pmcid: 7770278
doi: 10.2337/dc20-1096
Foster GD, Borradaile KE, Sanders MH, Millman R, Zammit G, Newman AB et al (2009) A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med 169(17):1619–1626
pubmed: 19786682
pmcid: 2879275
doi: 10.1001/archinternmed.2009.266
Bolinder J, Ljunggren Ö, Kullberg J, Johansson L, Wilding J, Langkilde AM et al (2012) Effects of dapagliflozin on body weight, total fat mass, and regional adipose tissue distribution in patients with type 2 diabetes mellitus with inadequate glycemic control on metformin. J Clin Endocrinol Metab 97(3):1020–1031
pubmed: 22238392
doi: 10.1210/jc.2011-2260