Risk of Hyperlactatemia in Obstructive Sleep Apnea Patients Receiving Metformin: A Critical Analysis

Strategic Insights -

A new study published in the journal Sleep and Breathing has shed light on the risk of hyperlactatemia in patients with obstructive sleep apnea (OSA) receiving metformin. The research, conducted by investigators from the Jagiellonian University Medical College, aimed to identify factors affecting lactate concentrations and the consequent risk of hyperlactatemia in patients with OSA. The findings suggest that metformin use increases the risk of hyperlactatemia in actively smoking patients, emphasizing the need for targeted interventions to encourage smoking cessation in this population.

Key Takeaways:

  • The study involved a total of 505 patients with obstructive sleep apnea, who underwent a detailed clinical evaluation and diagnostic nocturnal polysomnography.
  • The median lactate concentration across the cohort was 1.0 mmol/L, and did not differ by OSA severity (p = 0.82).
  • 18.8% of patients used metformin and exhibited higher lactate concentrations compared to those not receiving the medication (p < 0.8 mmol/L).
  • Hyperlactatemia was defined as serum lactate levels ≥ 4.5 mmol/L, which was detected in 64.8% of patients.
  • Multivariable analysis revealed that hyperlactatemia was associated with metformin use (p = 0.002) and active smoking (p = 0.04).
  • The study's findings indicate that the risk of hyperlactatemia increases in actively smoking patients treated with metformin, highlighting the need for targeted interventions to encourage smoking cessation.

Statistics:

  • 505 patients with obstructive sleep apnea were included in the study.
  • 18.8% of patients used metformin, while 81.2% did not receive the medication.
  • The median lactate concentration across the cohort was 1.0 mmol/L.
  • 64.8% of patients exhibited serum lactate levels ≥ 4.5 mmol/L, indicative of hyperlactatemia.
  • Active smoking was detected in 45.9% of patients.

Sources:

  • Research: Risk of hyperlactatemia in patients with obstructive sleep apnea receiving metformin: a cross-sectional study. Sleep and Breathing, 2025;29(5):309.
  • Publisher: Springer Heidelberg, Tiergartenstrasse 17, D-69121 Heidelberg, Germany.