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Obesity, Sleep Apnea, and Insulin Resistance

This study has been completed.
Information provided by (Responsible Party):
Gerald M Reaven, Stanford University Identifier:
First received: July 7, 2014
Last updated: March 14, 2017
Last verified: March 2017
Obstructive sleep apnea (OSA) and type 2 diabetes confer increasing economic, social, and public health burdens in the United States. That these diseases appear to co-exist and together increase one's risk of cardiovascular disease renders investigation into their shared pathophysiology even more urgent. Investigators will assess prevalence of insulin resistance, a precursor to diabetes, among overweight patients with OSA. Among those at highest risk of diabetes, investigators will randomize participants to pioglitazone or placebo to see the efficacy of the intervention on improving OSA, insulin resistance, and/or insulin secretion. In a separate intervention, investigators will evaluate the cardiometabolic benefits of continuous positive airway pressure (CPAP) for 12 weeks in patients with OSA. Investigators will also study subjects from the community without known sleep apnea, and assess whether insulin-resistant individuals are at risk for sleep apnea using clinical screening questionnaires.

Condition Intervention
Insulin Sensitivity Obstructive Sleep Apnea Drug: Pioglitazone Drug: placebo

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant
Primary Purpose: Other
Official Title: Interfacing Adiposity, Sleep Apnea, and Insulin Resistance

Resource links provided by NLM:

Further study details as provided by Gerald M Reaven, Stanford University:

Primary Outcome Measures:
  • Change in Apnea-hypopnea Index (AHI) Outcome Measure in Response to Pioglitazone or Placebo [ Time Frame: 8 weeks ]
    To evaluate the effects of pioglitazone versus placebo on AHI in patients with OSA.

Enrollment: 45
Study Start Date: September 2010
Study Completion Date: March 2015
Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: pioglitazone
pioglitazone 45 mg, oral, daily
Drug: Pioglitazone
45 mg daily Insulin sensitizing
Other Name: actos
Placebo Comparator: placebo
Placebo, one pill daily
Drug: placebo
Compare with pioglitazone


Ages Eligible for Study:   30 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Healthy Individuals
  • Age 30-70 years old
  • BMI- 25-40 kg/m2
  • Must meet criteria for obstructive sleep apnea by overnight in-laboratory polysomnography

Exclusion Criteria:

  • Any significant co-morbidities, such as diabetes, active heart, kidney, liver diseases, or active or history of bladder cancer.
  • Must not have previously received treatment for OSA, including CPAP.
  • Must not be receiving any medications intended for weight loss, or those known to influence insulin sensitivity.
  • Pregnancy/lactation is also an exclusion.
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Please refer to this study by its identifier: NCT02192684

Sponsors and Collaborators
Stanford University
Principal Investigator: Gerald M Reaven, M.D. Stanford University
  More Information

Responsible Party: Gerald M Reaven, Professor Emeritus, Stanford University Identifier: NCT02192684     History of Changes
Other Study ID Numbers: 5U01HL108647-04 ( US NIH Grant/Contract Award Number )
Study First Received: July 7, 2014
Results First Received: November 18, 2016
Last Updated: March 14, 2017

Keywords provided by Gerald M Reaven, Stanford University:
obstructive sleep apnea
insulin sensitivity
cardiovascular risk
positive airway pressure therapy

Additional relevant MeSH terms:
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Insulin Resistance
Respiration Disorders
Respiratory Tract Diseases
Signs and Symptoms, Respiratory
Signs and Symptoms
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases
Immune System Diseases
Glucose Metabolism Disorders
Metabolic Diseases
Insulin, Globin Zinc
Hypoglycemic Agents
Physiological Effects of Drugs processed this record on June 23, 2017