Obstructive sleep apnoea is frequent in patients with type 1 diabetes

Banghoej, Anne Margareta; Nerild, Henriette H.; Kristensen, Peter; Pedersen‐Bjergaard, Ulrik; Fleischer, Jesper; Jensen, Andreas Tue Ingemann; Laub, M.; Thorsteinsson, Birger; Tarnow, Lise

doi:10.1016/j.jdiacomp.2016.10.006

Cited by 34 publications

(31 citation statements)

References 29 publications

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“…Using an AHI of 5, multiple studies have found high rates (45%-63%) of SDB. 77,78 Using an AHI cutoff of 10, studies reported the prevalence of SDB to be 27%-46%. 77,79 Using a cutoff of 15, the prevalence rates have ranged from 8% to 40%.…”

Section: Sleep-disordered Breathingmentioning

confidence: 99%

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<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

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2020

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Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results from destruction of beta cells in the pancreas. Several reviews have concluded that sleep contributes to poor glycemic control, diabetes management, and diabetes-related complications in individuals with T1DM and represents an untapped opportunity for intervention. However, at the current juncture, the American Diabetes Association's Standards of Medical Care are devoid of recommendations about how to address sleep in the management of T1DM. This article summarizes reviews of sleep in youth and adults with T1DM and empirical studies that have examined various sleep parameters ranging from sleep disturbances (general, perceived sleep quality, sleepiness, awakenings, and sleep efficiency), sleep duration, sleep consistency, sleep-disordered breathing (SDB), and sleep architecture. The data show that many individuals with T1DM sleep less than recommendations; individuals with the poorest sleep have difficulties with diabetes management; and sleep deficiency including SDB often corresponds to several disease morbidities (neuropathy, nephropathy, etc). Mixed findings exist regarding direct associations of various sleep parameters and glycemic control. SDB appears to be just as prevalent, if not more, than other conditions that have been recommended for universal screening in individuals with T1DM. The article concludes with recommendations for collaborative research efforts to further elucidate the role of sleep in diabetes-related outcomes; investigations to test behavioral strategies to increase sleep quantity and consistency; and considerations for clinical care to address sleep.

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Section: Sleep-disordered Breathingmentioning

confidence: 99%

“…77,78 Using an AHI cutoff of 10, studies reported the prevalence of SDB to be 27%-46%. 77,79 Using a cutoff of 15, the prevalence rates have ranged from 8% to 40%. 78,8,81 Using an AHI > or ≥ 30, studies have found rates from 6% to 25%.…”

Section: Sleep-disordered Breathingmentioning

confidence: 99%

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

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2020

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“…Yet other studies have shown relations between hypoglycemia and increased sleep efficiency and fewer nighttime awakenings . Further, there is evidence showing T1D is associated with higher prevalence rates of obstructed sleep apnea, which may contribute to disease complications, suboptimal glycemic control, and further impact sleep quality. Because the associations between sleep behaviors and glucose variability are likely very individualistic, future studies should consider within‐person designs.…”

Section: Conceptual Modelsmentioning

confidence: 99%

Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications

Monzon

McDonough²,

Meltzer

et al. 2018

Pediatr Diabetes

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Youth with type 1 diabetes mellitus (T1D) experience more sleep disturbances and shorter sleep durations compared to their healthy peers. Researchers have now uncovered the negative mental health and physical health outcomes associated with poor sleep in youth with T1D. The field of T1D sleep research currently operates under the broad notion that sleep behaviors impact treatment adherence, which ultimately lead to worse long‐term health outcomes. This model however does not explain how behavior influences T1D management and sleep outcomes on a day‐to‐day basis, leading to difficulties in providing tailored treatment recommendations. In this review, we present a theoretical framework that describes the recursive cycle between sleep behaviors, T1D outcomes, and symptoms of negative affect/stress over a 24‐hour period. This model is guided by the sleep literature, showing a clear relationship between poor sleep and negative affect, and the T1D literature demonstrating a link between poor sleep and disease management for youth with T1D. Further, emerging literature indicates a need for additional parent sleep assessment considering that T1D management and fear of hypoglycemia negatively impact parent sleep behaviors. Recommendations are provided to move the field toward effective intervention studies and new areas of research to evaluate and modify the proposed model.

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“…Autonomic neuropathy was suggested as one potential mechanism for the high prevalence of OSA in T1D as shown in a cross-sectional study of 199 patients with T1D in which OSA was present in 32% of the patients with normal BMI (161). And another study showed a higher prevalence of OSA in patients with T1D and cardiac autonomic neuropathy compared to patients with T1D but without neuropathy (67 vs 23%) (162).…”

Section: Osa and T1dmentioning

confidence: 99%

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

Lavrentaki

Ali

Cooper

et al. 2019

European Journal of Endocrinology

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Obstructive sleep apnoea (OSA) is a common disorder that is associated with serious comorbidities with a negative impact on quality of life, life expectancy and health costs. As OSA is related to obesity and is associated with sleep disruption, increased inflammation and oxidative stress, it is not surprising that OSA has an impact on the secretion of multiple hormones and is implicated in the development of many endocrine conditions. On the other hand, many endocrine conditions that can affect obesity and/or upper airways anatomy and stability have been implicated in the development or worsening of OSA. This bidirectional relationship between OSA and the endocrine system has been increasingly recognised in experimental and epidemiological studies and there are an increasing number of studies examining the effects of OSA treatment on endocrine conditions and vice versa. In this review article, we will critically appraise and describe the impact of OSA on the endocrine system including obesity, dysglycaemia, the pituitary, the thyroid, the adrenals, the reproductive system and the bones. In each section, we will assess whether a bidirectional relationship exists, and we will describe the potential underlying mechanisms. We have focused more on recent studies and randomised controlled trials where available and attempted to provide the information within clinical context and relevance.

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Obstructive sleep apnoea is frequent in patients with type 1 diabetes

Cited by 34 publications

References 29 publications

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

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