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dc.contributor.authorCrofts, CAPen_NZ
dc.contributor.authorNeill, Aen_NZ
dc.contributor.authorCampbell, Aen_NZ
dc.contributor.authorBartley, Jen_NZ
dc.contributor.authorWhite, DEen_NZ
dc.date.accessioned2019-07-15T00:22:59Z
dc.date.available2019-07-15T00:22:59Z
dc.date.copyright2018-03-28en_NZ
dc.identifier.citationJournal of Insulin Resistance, 3(1), 1-6.
dc.identifier.issn2412-2785en_NZ
dc.identifier.urihttp://hdl.handle.net/10292/12662
dc.description.abstractBackground: 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.en_NZ
dc.publisherAOSISen_NZ
dc.relation.urihttps://insulinresistance.org/index.php/jir/article/view/34en_NZ
dc.rights© 2018. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
dc.subjectSleep apnoea; Metabolic disease; Sympathovagal balance; Sleep architecture; Hyperinsulinaemia
dc.titleSleep Architecture, Insulin Resistance and the Nasal Cycle: Implications for Positive Airway Pressure Therapyen_NZ
dc.typeJournal Article
dc.rights.accessrightsOpenAccessen_NZ
dc.identifier.doi10.4102/jir.v3i1.34en_NZ
aut.relation.endpage6
aut.relation.issue1en_NZ
aut.relation.pages6
aut.relation.startpage1
aut.relation.volume3en_NZ
pubs.elements-id334187
aut.relation.journalJournal of Insulin Resistanceen_NZ


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