Effect of obstructive sleep apnea on type 2 diabetes mellitus: A comprehensive literature review

Nannapaneni, Srikant; Ramar, Kannan; Surani, Salim

doi:10.4239/wjd.v4.i6.238

Cited by 82 publications

(70 citation statements)

References 65 publications

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“…These findings indicate that although, all the TRD residual symptoms are not caused by OSA, patients with TRD could be at high risk for OSA and they should be evaluated for sleep apnea, particularly in subjects with loud snoring, medical diseases, fatigue, and Additional findings demonstrated a positive link between high risk for OSA and the frequency of medical comorbidity, such as hypertension, diabetes mellitus, and obesity. This is supported by evidence regarding the comorbidity of these medical conditions with both MDD and OSA (6,(47)(48)(49)(50)(51)(52). This study observed that obesity is the strongest risk factor for OSA, as 43 of 44 obese patients with TRD were at high risk for OSA (Table 3).…”

Section: U N C O R R E C T E D P R O O Fsupporting

confidence: 69%

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Khazaie

Alavi-Mehr

Younesi

et al. 2018

Iran J Psychiatry Behav Sci

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Objectives: Studies have reported a higher risk for obstructive sleep apnea (OSA) in major depressive disorder (MDD). However, the risk of OSA in patients with chronic treatment-resistant depressive symptoms is not well documented worldwide. Hence, the current study assessed the risk of OSA and associated factors in patients with chronic treatment resistant depression (cTRD). Methods: The study recruited 140 Iranian patients with cTRD. All patients completed the Berlin questionnaire, which evaluates the risk of OSA. Additionally, demographic data and history of cardiovascular or metabolic diseases were collected. Pearson's Chi-square test, Fisher's exact test, and independent T-test were used to assess group differences, when appropriate. Results: The study found that 89 of 140 cTRD patients (64%) were at high risk for OSA. Group comparison between cTRD patients (high vs. low risk for OSA) demonstrated that at high risk OSA-cTRD patients had an elevated rate of hypertension, diabetes mellitus, and obesity. Also, age, duration of depression, and duration of treatment were significantly higher in cTRD patients with higher risk compared to those with lower risk for OSA. Conclusions:The results suggest that a noticeable number of patients with cTRD are at high risk for OSA, which is higher than the reported magnitude in the general population. Moreover, hypertension, diabetes mellitus, and obesity are associated with a higher risk for OSA. Also, age, treatment duration, and depression duration could be considered as possible comorbid factors for OSA in patients with cTRD.

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Section: U N C O R R E C T E D P R O O Fsupporting

confidence: 69%

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Khazaie

Alavi-Mehr

Younesi

et al. 2018

Iran J Psychiatry Behav Sci

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“…Increasing severity of obstructive sleep apnea has been linked to increased prevalence, and worsened control, of the metabolic syndrome and type 2 DM [30].…”

Section: Diabetic Cardiac Autonomic Neuropathy (Dcan)mentioning

confidence: 99%

Diabetes Mellitus and the Cardiovascular System

Kolakalapudi¹,

Omar²

2015

J Endocrinol Metab

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Diabetes mellitus (DM) is an epidemic which affects close to 100 million patients worldwide; the majority being type 2 diabetes mellitus. The rising incidence has resulted in a proportional increase in the frequency of cardiovascular disease attributable to DM, as revealed by various population-based studies. Over the past 50 years, DM has been shown to be an important and independent risk factor in the development of a variety of cardiac conditions, especially vascular disease, primarily through accelerated atherosclerosis. Diabetic neuropathy is a serious complication of DM, which leads to the impairment of cardiovascular autonomic control. Diabetic cardiac autonomic neuropathy results in heart rate abnormalities, exercise intolerance, orthostatic blood pressure abnormalities, QT interval prolongation, silent ischemia and diabetic cardiomyopathy, all of which lead to increased morbidity and mortality related to diabetes. This conditions remains difficult to diagnose and treat, requiring a multifaceted approach. Inflammation appears to play a central role in accelerating many of the injurious effects of DM on the cardiovascular system. Expression of specific inflammatory markers has been directly linked to some of the known harmful effects of DM on the cardiovascular system, in addition to indirectly potentiating the deleterious effects of other major cardiovascular disease risk factors. Hyperglycemia results in increased intracellular glucose which triggers several pro-inflammatory reactions leading to the production of harmful free radicals and the formation of advanced glycation end products. These have been linked to the development of diabetic atherogenic dyslipidemia, in addition to glycation and loss of the protective effect of high density lipoproteins in diabetic subjects, thereby worsening the atherosclerotic burden in DM. Addressing hyperglycemia, therefore, is only one of many vital components in the treatment of diabetes. Traditional risk factors for heart disease and stroke tend to be further potentiated by the presence of DM, however, even after adequate control of hyperglycemia. Clinical evidence and major clinical guidelines address this conundrum by pointing out unmet needs of adequate cardiovascular protection, and call for aggressive control of risk factors in the diabetic population.

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“…Approximately 10% of the onset of type-2 diabetes can be attributed to SDB. Both SDB and type-2 diabetes are frequently associated with obesity and metabolic syndrome and it is therefore not uncommon to find individuals affected by one or the other 17) . Cross-sectional estimates from population and clinic studies suggest that up to 40% of patients with OSAS have diabetes, likewise, in patients known to have diabetes, the prevalence of OSAS may be up to 23% and the prevalence of some form of SDB may be as high as 58% 17) 18) .…”

Section: ) 14) 15)mentioning

confidence: 99%

Significance of Early Detection and Treatment of Sleep Apnea Syndrome

Filomeno

Ikeda

Tanigawa

2017

Juntendo Medical Journal

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Sleep disordered breathing (SDB) is an umbrella term for several chronic conditions in which partial or complete cessation of breathing occurs many times throughout the; one SDB condition in particular, obstructive sleep apnea syndrome (OSAS), has been globally recognized as a growing public health issue. OSAS is a chronic disease involving repetitive pauses in breathing during sleep that can cause numerous health issues if left untreated such as increased risk for hypertension, coronary heart disease, type-2 diabetes, stroke and depression.Daytime sleepiness, which can occur secondary to OSAS, impacts oneʼs ability to operate a motor vehicle properly and is likened to driving under the influence of alcohol. Early screening has the potential to identify OSAS and initiate subsequent treatment, which can improve breathing during sleep and decrease daytime sleepiness. The significance of early detection cannot be overlooked, as the far-reaching effects of OSAS have large public health implications.

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Effect of obstructive sleep apnea on type 2 diabetes mellitus: A comprehensive literature review

Cited by 82 publications

References 65 publications

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Diabetes Mellitus and the Cardiovascular System

Significance of Early Detection and Treatment of Sleep Apnea Syndrome

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