SDB and metabolic disorders

Sleep apnea is common among patients with type 2 diabetes.1 It is independently associated with insulin resistance, glucose intolerance and metabolic syndrome,2-4 and when untreated, can lead to poor overall treatment outcomes.

However, despite the number of type 2 diabetes patients with SDB, it largely goes undiagnosed.

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

  • 01

    Einhorn D et al. Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract 2007;13(4):355–62.

  • 02

    Aronsohn RS et al. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med 2010;181(5):507–13.

  • 03

    Punjabi NM et al. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 2002;165(5):677–82.

  • 04

    Coughlin SR et al. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 2004;25(9):735–41.

  • 05

    Resnick HE et al. Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 2003;26(3):702-9.

  • 06

    Meslier N et al. Impaired glucose-insulin metabolism in males with obstructive sleep apnea syndrome. Eur Respir J 2003;22(1):156-60.

  • 07

    Punjabi NM et al. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004;160(6):521-30.

  • 08

    Harsch IA et al. 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.

  • 09

    Babu AR et al. Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med 2005;165(4):447-52.