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Observational Study
. 2024 Jan 1;20(1):67-73.
doi: 10.5664/jcsm.10796.

Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome

Matteo Carpi  1 , Alberto Cordella  2 , Fabio Placidi  1   3 , Francesca Izzi  1 , Eleonora Piccirilli  4 , Nicola Biagio Mercuri  1   3 , Umberto Tarantino  4 , Claudio Liguori  1   3
Affiliations
Observational Study

Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome

Matteo Carpi et al. J Clin Sleep Med. .

Abstract

Study objectives: Obstructive sleep apnea (OSA) and low bone mineral density (BMD) are 2 prevalent conditions with a significant negative impact on patients' well-being and quality of life. Recent research has shown low BMD at different bone sites in male patients with OSA. Although the efficacy of continuous positive airway pressure (CPAP) treatment for OSA has been widely demonstrated, the evidence for understanding its impact on BMD and other bone-related outcomes is insufficient. The aim of this observational study was to investigate the effect of 12 months of CPAP treatment on lumbar and femur BMD and bone-related serum biomarkers in male patients with severe OSA.

Methods: Sixty patients (mean age: 55.1 ± 9.9 years) were consecutively included and underwent BMD measurement with dual-energy x-ray absorptiometry at baseline and after 12 months of CPAP treatment. Vitamin D, parathyroid hormone, and calcium serum levels were examined at the same time points.

Results: A significant increase in BMD in the L1 (P < .001, d = 0.27) and L2 (P < .001, d = 0.26) vertebrae was observed after CPAP treatment, along with an increase in vitamin D (P < .001, d = 0.71) and calcium (P < .001, d = 0.73) levels and a decrease in parathyroid hormone levels (P < .001, d = 0.60). The increase in BMD in L1 was significantly correlated with the decrease in parathyroid hormone serum levels (r = -.50, P < .001).

Conclusions: Overall, these findings showed that beneficial OSA treatment might restore bone health and support CPAP treatment as a feasible strategy to improve BMD in male patients with severe OSA. Accordingly, diagnosing and targeting OSA may be warranted in the treatment of male patients with undetermined osteopenia and osteoporosis.

Citation: Carpi M, Cordella A, Placidi F, et al. Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome. J Clin Sleep Med. 2024;20(1):67-73.

Keywords: bone mineral density; hypoxia; obstructive sleep apnea; osteoporosis; vitamin D.

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Conflict of interest statement

All authors read and approved the final version of the manuscript. Work for this study was performed at University Hospital of Rome Tor Vergata. This research received support from the University of Rome Tor Vergata (grant related to the project “Consolidate the Foundations”). The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Flowchart illustrating the participants’ selection process for the study.
See this image and copyright information in PMC

Comment in

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