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Diabetes and sleep apnea

Among people with diabetes, the prevalence of sleep apnea is very high (up to 58%).1 Similarly, there is a high prevalence of impaired glucose tolerance and diabetes among people with sleep apnea (in one study 50% of male sleep apnea patients had abnormal glucose tolerance, and 30% of them had diabetes).2

Obesity is a common and contributing factor to both sleep apnea and diabetes. However, despite the significance of obesity in both these diseases, studies have shown that sleep apnea is an additional contributing factor that is independently associated with glucose intolerance and insulin resistance, regardless of obesity.3,4 Insulin resistance is a precursor to diabetes.

CPAP may improve insulin sensitivity and glycemic control in patients with sleep apnea, particularly for non-obese patients.5,6

References

1

Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, Ewy GA, Howard BV, Punjabi NM; Sleep Heart Health Study. Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 2003;26(3):702-9.

2

Meslier N, Gagnadoux F, Giraud P, Person C, Ouksel H, Urban T, Racineux JL. Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome. Eur Respir J 2003;22(1):156-60.

3

Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE; Sleep Heart Health Study Investigators. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004;160(6):521-30.

4

Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men.  Am J Respir Crit Care Med 2002;165(5):677-82.

5

Harsch IA, Schahin SP, Radespiel-Troger M, Weintz O, Jahreiss H, Fuchs FS, Wiest GH, Hahn EG, Lohmann T, Konturek PC, Ficker JH. Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2004;169(2):156-62.

6

Babu AR, Herdegen J, Fogelfeld L, Shott S, Mazzone T. Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea.  Arch Intern Med 2005;165(4):447-52.