Sleep Apnea and Diabetes: Insights into the Emerging Epidemic

Abstract

The rampant diabetes pandemic over the last few decades has been associated with an increased rise in cardiovascular events and deaths. Risk factors such as obesity, family history of diabetes, decreased physical activity, and aging are among the most common in the development of diabetes. Emerging evidence in the last 10 years has suggested that sleep apnea is a novel risk factor in the development of diabetes. Associations between diabetes and sleep apnea are supported by both epidemiologic and clinical sleep apnea studies. In this report, we discuss epidemiologic and clinical evidence suggesting that sleep apnea is involved in the pathogenesis of altered glucose metabolism. In light of current evidence, sleep apnea treatment should be incorporated into existing pharmacotherapeutic regimens for optimal management of diabetes among diabetic patients with sleep apnea in order to reduce associated cardiovascular risk. Suggestions to improve practice guidelines in the management of diabetic patients with sleep apnea are provided.

Population-based cohort study on the increase in the risk for type 2 diabetes mellitus development from nonapnea sleep disorders

“…Among sleep disorders, sleep-related breathing disorders, such as central sleep apnea syndrome, obstructive sleep apnea (OSA) syndrome, and sleep-related hypoventilation and hypoxemia syndrome are novel risk factors for the development of DM [8]. 1389 Associations between DM and sleep apnea were supported by both epidemiologic surveys and laboratory studies [9,10].…”

The Concomitant Relationship Shared by Sleep Disturbances and Type 2 Diabetes: Developing Telemedicine as a Viable Treatment Option

“…This noninvasive treatment operates by ventilating air through the mouth and nose during sleep, thereby decreasing sleep fragmentations and other sleep abnormalities. 5 Utilizing CPAP intervention on a regular basis results in enhanced maintenance of normal glucose levels, improved insulin sensitivity, and better maintenance of appropriate leptin and ghrelin hormone levels. 5,12 Previous research has demonstrated that those diagnosed both with diabetes and an SD who were complaining of fatigue and excessive daytime sleepiness were prescribed a CPAP for several months.…”

“…5,6 Although diabetes management is improving, complications are still common, and diabetes remains the leading cause of visual loss, amputation, and end stage of renal disease in the United States. 2,5,6 Similar to diabetes, sleep disturbances are related to myriad health problems, affecting approximately 70 million Americans. 1 The extent to which sleep disorders (SDs) affect overall health and functionality has not been clearly ascertained because significant inadequate diagnoses and underdiagnoses of SDs; an estimated 85% of SDs go undiagnosed or untreated.…”

“…9 These factors are primarily influenced by family history, aging, weight gain, and lack of exercise. 5,12,17 Obesity, particularly abdominal obesity, is recognized as a risk factor for insulin resistance, hypertension, metabolic syndrome, and obstructive sleep apnea (OSA). 17 As obesity increases the risk of SDs, hypertension, and insulin resistance, the risk of type 2 diabetes also increases.…”

Bi-Directional Relationship Between Sleep Problems and Psychiatric Disorders

“…10 The far-reaching effects of sleep disorders and deprivation underscore the need for evaluation and treatment of sleep problems in patients with various psychiatric conditions.…”