Metabolism and Sleep Apnea Treatment

Aim 1 Group:

Inclusion criteria:

• Age between 18-70 years

• Ability to provide consent

Exclusion criteria

• Body Mass Index (BMI) > 40 kg/m2

• Prevalent myocardial infarction, coronary revascularization, heart failure, andstroke

• Type 1 or Type 2 diabetes mellitus

• Current or prior use of PAP or oral appliance therapy for OSA

• Use of oral corticosteroids

• Unstable medical conditions that may preclude enrollment in the protocol such as:uncontrolled angina and/or congestive heart failure, uncontrolled blood pressure orresistant hypertension, severe chronic obstructive pulmonary disease, cancer, andactive psychiatric disease (e.g., major depression)

• Other sleep disorders (e.g., circadian rhythm disorder, self-reported habitual sleepduration < 6h)

• Use of supplemental oxygen during wakefulness or sleep

• Central sleep apnea, obesity hypoventilation syndrome or Cheyne-Stokes respirationbased on the home sleep test

• Resting awake Oxygen Saturation (SpO2) < 90%

Aim 2 Group:

Inclusion criteria:

• Age between 18-70 years

• Ability to provide consent

• Moderate-to-severe OSA (AHI ≥ 15/h);

• Demonstration of Positive Airway Pressure (PAP) use of > 4 h/night on 70% of thenights during 1-week run-in period

• Successful completion of all of the procedures for Aim 1.

Exclusion criteria:

• BMI: ≥ 40 kg/m2

• Type 1 or Type 2 diabetes mellitus

• Current use of PAP or oral appliance therapy for OSA

• Commercial driver or report of motor vehicle accident or near-miss due to sleepinesswithin the 2 previous years

• Epworth sleepiness score of 18 or more

• Use of oral corticosteroids

• Participation in another clinical trial

• Unstable medical conditions that may preclude enrollment in the protocol such as:uncontrolled angina and/or congestive heart failure, uncontrolled blood pressure orresistant hypertension, severe chronic obstructive pulmonary disease, cancer, andactive psychiatric disease (e.g., major depression)

• Other sleep disorders (e.g., circadian rhythm disorder, self-reported habitual sleepduration < 6h)

• Use of supplemental oxygen during wakefulness or sleep

• Central sleep apnea, obesity hypoventilation syndrome or Cheyne-Stokes respirationbased on the home sleep test

• Resting awake SpO2 < 90%