Sleep Apnea May Complicate Diabetes Care

Study Shows Glucose Control Is Affected by Obstructive Sleep Apnea

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

Jan. 15, 2010 -- Untreated obstructive sleep apnea may affect the health of people with type 2 diabetes, a new study shows.

Obstructive sleep apnea is a treatable disorder that results in episodes of stopped breathing due to blockages in the airway during sleep.

The sleeping disorder may adversely affect glucose control, making the health problems associated with type 2 diabetes even worse, University of Chicago scientists report in the American Journal of Respiratory and Critical Care Medicine, a publication of the American Thoracic Society.

The study, involving 60 people with type 2 diabetes, demonstrates "for the first time that there is a clear, graded inverse relationship between [obstructive sleep apnea] severity and glucose control in patients with type 2 diabetes," says study researcher, Renee S. Aronsohn, MD, of the University of Chicago, in a news release.

The study also shows:

  • Undiagnosed obstructive sleep apnea is very common among people with type 2 diabetes.
  • Sleep apnea is a largely undiagnosed additional medical risk factor for people with diabetes.
  • Sleep apnea is associated with poorer glucose control and could lead to even more health complications for diabetes patients.

Researchers say doctors should ask their patients with type 2 diabetes about sleeping problems. John Heffner, MD, past president of the American Thoracic Society, says in the news release that at least 80% of doctors' patients with type 2 diabetes would be found to also have obstructive sleep apnea, which is a treatable condition.

"Treating their breathing problem might improve their glycemic control" and ease some of the complications of diabetes, Heffner says.

Aronsohn says the study has "important clinical implications" and that effective treatment of obstructive sleep apnea "may represent a novel and non-pharmacologic intervention" in diabetes management.

She and her fellow researchers recruited adults with type 2 diabetes (41 to 77 years old) from outpatient clinics. The researchers gathered information on the participants' medical history and height and weight measurements; they monitored each person's sleep-wake patterns.

Patients also underwent an overnight sleep study to determine whether they had sleep apnea.

Three-quarters of the participants had obstructive sleep apnea, the researchers say. Despite such a high percentage of people with the sleep disorder, only five had been evaluated for it, and none was undergoing treatment.

Thirty-eight percent of the participants (23 people) were classified as having mild sleep apnea, 25% (15 people) had moderate apnea, and 13% (eight people) had severe sleep apnea, the researchers say.

The researchers report that people with sleep apnea were heavier and older than those without sleep apnea. Increasing severity of sleep apnea was clearly associated with poorer glucose control, even after taking into account factors such as obesity, which the researchers say implies potentially more complications for diabetes patients.

The researchers say the relationship between obstructive sleep apnea and severity of diabetes seems clear.

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SOURCES: News release, American Thoracic Society.

Aronsohn, R. American Journal of Respiratory and Critical Care Medicine, published online Dec. 17, 2009.

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