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Volume 14 No. 03
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Accepted Papers

Scientific Investigations

The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients With Obstructive Sleep Apnea

Andreas Palm, MD1,2; Christian Berne, MD, PhD3; Helena Igelström, PhD4; Pernilla Åsenlöf, PhD4; Christer Janson, MD, PhD1; Eva Lindberg, MD, PhD1
1Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden; 2Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden; 3Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden; 4Department of Neuroscience, Section of Physiotherapy, Uppsala University, Uppsala, Sweden

Study Objectives:

Obstructive sleep apnea (OSA) is a disease with metabolic and cardiovascular consequences and is associated with decreased serum concentrations of insulin-like growth factor-1 (IGF-1). The aim of this study was to investigate whether continuous positive airway pressure (CPAP) will increase serum IGF-1 concentration in patients with OSA.


Patients with moderate to severe OSA were recruited from a sleep clinic and serum IGF-1 was measured before initiation of CPAP and at follow-up after 4.8 ± 2.5 months. Patients adherent to CPAP treatment (usage ≥ 4 h/night) were compared with those considered to be nonadherent (usage < 4 h/night).


Complete data were obtained from 69 patients (86% male, age 56 ± 12 years, respiratory event index 43 ± 21 events/h, Epworth Sleepiness Scale score 12 ± 5). In those adherent to CPAP (n = 42), there was an increase in serum IGF-1 concentration with 21.1 (95% confidence interval [CI]: 13.1 to 29.2) μg/L compared to 4.7 (95% CI: −4.1 to 13.5) μg/L in the nonadherent group (n = 27) (P = .0083). In a linear multivariate model adjusting for sex, age, body mass index, respiratory event index, and mean oxygen saturation during the night recording, the change in serum IGF-1 concentration was significantly associated with adherence to CPAP treatment (adjusted β coefficient: 21.8, 95% CI: 10.2 to 33.4) and inversely associated with change in body mass index (adjusted β coefficient: −7.1, 95% CI: −11.3 to −3.0) and change in hemoglobin A1c (adjusted β coefficient: −1.8, 95% CI: −33 to −0.3).


CPAP usage ≥ 4 h/night is associated with increased serum IGF-1 concentration in male patients with OSA.


Palm A, Berne C, Igelström H, Åsenlöf P, Janson C, Lindberg E. The impact of continuous positive airway pressure on circulating IGF-1 in patients with obstructive sleep apnea. J Clin Sleep Med. 2018;14(3):385–391.

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