The prevalence and characteristics of obstructive sleep apnea in hospitalized patients with type 2 diabetes in China

Abstract

SUMMARYData on the prevalence of obstructive sleep apnea in subjects with type 2 diabetes mellitus in China is scarce. We conducted a multi-centre, cross-sectional study involving 12 hospitals from six regional cities to investigate the prevalence of obstructive sleep apnea in hospitalized patients with type 2 diabetes mellitus and to explore the association between obstructive sleep apnea and related risk factors, diabetic complications and comorbidities in China. Each hospital recruited at least 70 consecutive patients with type 2 diabetes mellitus who were admitted to the endocrinology ward. A total of 880 participants were enrolled and administered overnight sleep monitoring with a portable monitor (ApneaLink TM , ResMed, San Diego, CA, USA); other information was collected from medical charts and a standardized questionnaire. In this study, 60.0% (95% confidence interval: 56.8%, 63.2%) of hospitalized patients in China with type 2 diabetes mellitus had comorbid obstructive sleep apnea (apnea-hypopnea index ≥ 5). Only 1.5% (eight of 528) of the patients with both conditions had been diagnosed previously with obstructive sleep apnea. The prevalence of moderatesevere (apnea-hypopnea index ≥ 15) and severe obstructive sleep apnea (apnea-hypopnea index ≥ 30) was estimated to be 25.6% (22.7, 28.5%) and 10.3% (8.3, 12.4%), respectively. Age, sex, body mass index, snoring, reported breath-holding in sleep or gasping or choking arousal, sleepiness, diabetes duration, hypertension, diabetic nephropathy and cardiovascular diseases history were correlated significantly with the severity of obstructive sleep apnea. In China, the prevalence of obstructive sleep apnea in hospitalized patients with type 2 diabetes mellitus is high. Routine screening for and treatment of obstructive sleep apnea is an important, but often neglected, part of the management of diabetes.

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free‐living environments

“…Yet, unlike this previous study , we excluded patients with painful DPN (i.e. we only included painless DPN in those groups with DPN) or sleep apnoea, which are known to negatively impact on sleep , and their exclusion may explain why we did not find any daily sleep differences .…”

New Insight into the Role of Obstructive Sleep Apnea in Cardiometabolic Diseases

“…Despite the fact that a higher number of persons with OSA is recorded, because of the nonspecific symptoms, the non-diagnosis percentage is further increased (70-80%) [11].…”

“…In a study conducted by Zhang P. et al in China on a group of 880 subjects with type 2 diabetes, it was found a high overall prevalence of OSA (60%) and of moderate-severe OSA (25.6%) [11].…”

“…An increase in weight by 10% is associated with a six times fold increase in developing OSA, insulin resistance being one potential link between obesity and OSA [11].…”

“…The potential risk factors associated with OSA are [8,[11][12][13][14]:  Family history of OSA or snoring;  Otorhinolaryngology diseases: trachea malformations, deviated septum, hypertrophy of palatine tonsils (an increase of 3-4 times of the volume being considered significant), malformations of face configurations (maxillary malocclusion and micrognathia), malformation of the central incisors from the maxillary level;  Gender.  The prevalence of OSA is 2-3 folds higher in males than in premenopausal women, while in postmenopausal state OSA prevalence increases in women, with 2-3 times higher risk of OSA, the protective role of the women sexual hormones being a potential explanation.…”