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Can Sleep Apnea Cause Type 2 Diabetes?

Obstructive Sleep Apnea And Type 2 Diabetes: Is There A Link?

Obstructive Sleep Apnea And Type 2 Diabetes: Is There A Link?

Obstructive Sleep Apnea and Type 2 Diabetes: Is There a Link? 1Respiratory Division, Department of Medicine, McGill University, Montreal, QC, Canada 2Department of Medicine, The University of Chicago, Chicago, IL, USA Edited by: Sigrid Veasey, University of Pennsylvania, USA Reviewed by: Vsevolod Polotsky, Johns Hopkins University, USA; Sigrid Veasey, University of Pennsylvania, USA *Correspondence: Sushmita Pamidi, Respiratory Division, McGill University Health Centre, Room L4.05, 687 Pine Avenue West, Montreal, QC, Canada H3A1A1. e-mail: [email protected] This article was submitted to Frontiers in Sleep and Chronobiology, a specialty of Frontiers in Neurology. Received 2012 Jun 16; Accepted 2012 Jul 24. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc. This article has been cited by other articles in PMC. Type 2 diabetes is a chronic illness that is increasing in epidemic proportions worldwide. Major factors contributing to the development of type 2 diabetes include obesity and poor lifestyle habits (e.g., excess dietary intake and limited physical activity). Despite the proven efficacy of lifestyle interventions and the use of multiple pharmacological agents, the economic and public health burden of type 2 diabetes remains substantial. Obstructive sleep apnea (OSA) is a treatable sleep disorder that is pervasive among overweight and obese adults, who represent about two thirds of the U.S. population today. An ever-growing number of studies have shown that OSA is associated with insulin resistance, glucose intolerance Continue reading >>

Effect Of Obstructive Sleep Apnea On Type 2 Diabetes Mellitus: A Comprehensive Literature Review

Effect Of Obstructive Sleep Apnea On Type 2 Diabetes Mellitus: A Comprehensive Literature Review

Go to: Obstructive sleep apnea (OSA) is frequently associated with obesity and metabolic syndrome. Also frequently associated with metabolic syndrome is type 2 diabetes mellitus (T2DM). Therefore, it is common to find OSA and T2DM together in individuals with metabolic syndrome. Additionally, both OSA and T2DM have a common pathophysiological link with development of insulin resistance. Individuals with severe insulin resistance are likely to have inadequate glycemic control. Long standing poorly controlled T2DM is associated with debilitating microvascular complications such as retinopathy, nephropathy, neuropathy and macrovascular complications such as coronary artery and cerebrovascular disease. There is extensively published literature exploring the cause-effect relationship between OSA and T2DM. In this article we provide an in-depth review of the complex pathophysiological mechanisms linking OSA to T2DM. Specifically, this review focusses on the effect of OSA on the microvascular complications of T2DM such as retinopathy, nephropathy and neuropathy. Additionally, we review the current literature on the effect of continuous positive airway pressure use in individuals with T2DM and OSA. Keywords: Sleep apnea and diabetes, Obstructive sleep apnea and diabetic complications, Obstructive sleep apnea, Diabetic complications, Sleep related breathing disorder, Diabetes Continue reading >>

Considering The Relationship Between Type 2 Diabetes And Sleep Apnea

Considering The Relationship Between Type 2 Diabetes And Sleep Apnea

Considering the Relationship Between Type 2 Diabetes and Sleep Apnea Sleep apnea and type 2 diabetes are serious conditions that can potentially cause life-threatening complications. Learning about the relationship between the two can help sufferers of the conditions to successfully manage them. Sleep Apnea Obstructive sleep apnea (OSA) is a sleep disorder that causes sufferers to experience breathing interruptions throughout the night, which can cause symptoms such as loud snoring and sudden wakefulness. OSA can also cause serious health complications, including a higher risk of heart disease and heart-related problems, as well as type 2 diabetes. Although the disorder can affect anyone, those who are overweight or have a family history of sleep apnea, have a higher chance of developing OSA. Type 2 Diabetes Type 2 diabetes is a chronic condition in which the body elevates blood glucose (sugar) levels. The body fails to use insulin properly or becomes resistant to the effects of it. Initially, the pancreas produces extra insulin to stabilize the levels, but in the long-term, it can’t produce enough insulin to maintain them. Having one or more risk factors — such as being overweight, being inactive or having a family history of diabetes — can increase the chance of contracting the disease. Relationship Between Sleep Apnea and Type 2 Diabetes Diabetes affects roughly 25.6 million people in the U.S. who are 20 years old and over, according to the Centers for Disease Control and Prevention, and between 90 to 95 percent of these cases are type 2 diabetes. Around seven in 10 adults with type 2 diabetes also suffer from obstructive sleep apnea. In fact, the prevalence of sleep apnea can be as high as 72 percent in those with diabetes. When OSA is poorly managed, it makes Continue reading >>

The Type 2 Diabetes And Sleep Apnea Connection

The Type 2 Diabetes And Sleep Apnea Connection

People with type 2 diabetes are at risk for sleep apnea, a disorder that's marked by pauses in breathing during sleep. If you have type 2 diabetes, there’s another condition that you should be aware of: sleep apnea, a disorder in which people experience pauses in their breathing throughout the night, possibly for one minute or more. In fact, according to a study published in 2013 in Family Medicine, people with type 2 diabetes can have a nearly 50-50 chance of being diagnosed with this sleep disorder. That’s a problem, since sleep apnea can worsen diabetes symptoms and lead to problems like high blood pressure, heart disease, or even stroke, says David Marrero, PhD, president of healthcare and education at the American Diabetes Association and director of the Diabetes Translational Research Center at the Indiana University School of Medicine in Indianapolis. “Untreated sleep apnea is associated with increases in glucose and poor quality of life stemming from chronic fatigue,” says Dr. Marrero. “It’s also associated with cardiovascular disease, which is why it’s so important for people to get their sleep apnea diagnosed and treated.” Sleep apnea and type 2 diabetes often coexist because of shared risk factors like obesity. According to the American Academy of Sleep Medicine, the more severe the untreated sleep apnea in a person with type 2 diabetes, the poorer their levels of glucose control. Read on to learn more about sleep apnea and how you can treat it effectively. Sleep Apnea: It's More Than Just Snoring Sleep apnea is a sleep disorder that’s characterized by pauses in breathing. These episodes, called apneas, can wake the sleeper as he or she gasps for air, which can lead to poor sleep and chronic tiredness. The most common type of sleep apnea is Continue reading >>

Sleep Apnea And Diabetes

Sleep Apnea And Diabetes

Tweet Sleep Apnoea, also called sleep apnea, is a common breathing disorder that affects many people whilst they sleep, could be an early warning that diabetes development is underway. Numerous medical studies have linked obstructive sleep apnoea with greater risk of developing type 2 diabetes. According to experts, side effects directly related to sleep apnoea could influence the metabolism of people as they sleep. The condition is surprisingly common, to the extent that sleep apnoea has been termed: ‘the silent epidemic’. Sleep apnoea affects as many as one-tenth of middle-aged men, and manifests itself as an interruption of breathing during the hours of sleep. The correlation between sleep and diabetes is well-proven, with interruptions to deep sleep a key part of diabetes risk. Obesity makes both diabetes and sleep apnoea more likely. Why does sleep apnea damage the body and lead to greater risk of diabetes? Sleep apnoea is thought to be dangerous because it affects the concentration of oxygen within the bloodstream. It also plays havoc with sleep patterns, and can lead to daytime fatigue in more serious cases. The actual mechanism that causes sleep apnoea to influence oxygen If I have sleep apnea, am I a diabetic? Not necessarily, but having sleep apnoea does mean an increased risk of developing diabetes. Is OSAS the same as sleep apnea? OSAS stands for Obstructive Sleep Apnoea Syndrome. What are the symptoms of Sleep Apnea? Sleep Apnoea occurs when an obstruction gets in the way of air entering the lungs. These short periods of stopping breathing are generally limited to a less than 10 seconds, and can occur often during the night. Generally, the brain works the sleeping person up when apnoea occurs, often with a snore or snort. How serious is Sleep Apnea? Exp Continue reading >>

The Link Between Sleep Apnea And Diabetes

The Link Between Sleep Apnea And Diabetes

The American Diabetes Association estimates that nearly 30 million Americans live with diabetes. Even more concerning, diabetes is the 7th leading cause of death in the U.S. The condition can be caused by an autoimmune problem, where the body attacks the cells in the pancreas that produce insulin to keep blood sugar levels in check. This is known as type 1 diabetes. Or, the condition can be type 2 diabetes which arises from insulin resistance–where the body doesn’t respond to insulin and blood sugar remains at abnormal levels. Type 2 diabetes is more common and is not an autoimmune disease but rather a “lifestyle disease” once known as adult-onset or noninsulin-dependent diabetes. There is no cure for type 2 diabetes, but it can be managed and prevented. Type 2 diabetes is often associated with obesity, high blood pressure and heart disease, but recent research has pinpointed another condition that is linked as well: sleep apnea. Sleep apnea is more than just an issue with sleep quality. Sleep apnea is the interruption of breathing, typically caused when tissue in the back of the throat collapses into the airway, blocking the breath, and is associated with a host of health issues. Experts have grown certain that the disorder increases cardiovascular (heart) risk, for example. There’s also mounting evidence that sleep apnea may contribute to problems like insulin resistance, glucose intolerance and type 2 diabetes. “If you have hypertension (high blood pressure), you’re more likely to have obstructive sleep apnea; and if you have sleep apnea, you are more likely to have hypertension,”says Said Mostafavi, M.D., the Chief Medical Officer for Advanced Sleep Medicine Services, Inc. and a sleep specialist. “In the same way, if you have diabetes, you’re mor Continue reading >>

Sleep Apnea Increases Type 2 Diabetes Risk

Sleep Apnea Increases Type 2 Diabetes Risk

Years of research have suggested that there is a connection between obstructive sleep apnea (OSA) and Type 2 diabetes. Now, the largest study investigating the conditions to date has demonstrated a link between the severity of a person’s OSA and his risk of developing Type 2. OSA is a condition in which breathing stops for 10 seconds or more during sleep, sometimes hundreds of times a night. The disorder affects approximately 18 million people in the United States, and research has shown that the condition is associated with increased risk for cardiovascular death. To determine whether OSA increases the risk of developing diabetes, researchers from the University of Toronto looked at 8,678 adults with suspected OSA who underwent a sleep study between 1994 and 2010. The severity of each person’s sleep apnea was evaluated using a measurement known as the apnea-hypoapnea index (AHI), which indicates the number of times a person stops breathing or breathes irregularly each hour. Based on the results, the study subjects were placed into one of four OSA categories — none, mild, moderate, or severe — and were then followed through May 2011 to examine whether they went on to develop diabetes. Over the course of the follow-up period, 1,017 (11.7%) of the participants developed Type 2 diabetes. After adjusting for risk factors known to increase a person’s chances of developing the condition, including age, sex, body-mass index, neck circumference, smoking, and income status, people with severe OSA were found to have a 30% higher risk of developing Type 2 diabetes than people without OSA. Additionally, those with mild or moderate OSA were found to have a 23% increased risk of developing Type 2 compared to those without OSA. Additional risk factors for diabetes included e Continue reading >>

How Sleep Apnea Can Make You More Prone To Diabetes

How Sleep Apnea Can Make You More Prone To Diabetes

Sleep Apnea and Diabetes Obstructive Sleep Apnea (OSA) is a common disorder affecting over 20 million American adults, but did you know that Sleep Apnea and diabetes shares an unexpected link? It is estimated that nearly 40% of those diagnosed with Obstructive Sleep Apnea may have or may develop Diabetes. Conversely, of those diagnosed with Diabetes, 20% could potentially have, or develop, Sleep Apnea. [1] This year, the World Health Organization has chosen to focus on Diabetes to draw attention to the seriousness of the disorder and the rapid rise in its presence among people around the world. It is projected that Diabetes will be in the top 10 causes of death in 2030. [2] But what is Diabetes? Diabetes 101 In short, Diabetes is a condition where the sugar levels or glucose levels in the blood stream are not properly maintained. As glucose levels in the blood become unbalanced, varying symptoms can occur. [3],[4] Diabetes Symptoms • Thirst • Frequent Urination • Blurred Vision • Numbness in the Hands or Feet • Frequent Skin, Bladder or Gum Infections • Difficulty Healing From Wounds • Extreme Fatigue Types of Diabetes Type 1 Diabetes With Type 1 Diabetes, the body no longer produces insulin due to the body’s immune system attacking insulin producing cells. Without insulin the body cannot control glucose levels in the blood stream. Those with Type 1 Diabetes must take insulin every day and carefully manage their diet to properly maintain a healthy level of glucose. [5] Type 2 Diabetes The most common form of Diabetes is Type 2. With Type 2 Diabetes the body either doesn’t produce enough insulin or the insulin produced goes with little effect. In Type 2 Diabetes oral medications are used to help give the naturally present insulin a boost in its ability Continue reading >>

Type 2 Diabetes And Sleep

Type 2 Diabetes And Sleep

People who have diabetes often have poor sleep habits, including difficulty falling asleep or staying asleep. Some people with diabetes get too much sleep, while others have problems getting enough sleep. According to the National Sleep Foundation, 63% of American adults do not get enough sleep needed for good health, safety, and optimum performance. There are several causes of sleep problems for people with type 2 diabetes, including obstructive sleep apnea, pain or discomfort, restless legs syndrome, the need to go to the bathroom, and other problems associated with type 2 diabetes. Sleep apnea involves pauses in breathing during sleep. The periods of stopped breathing are called apneas, which are caused by an obstruction of the upper airway. Apneas may be interrupted by a brief arousal that does not awaken you completely -- you often do not even realize that your sleep was disturbed. Yet if your sleep was measured in a sleep laboratory, technicians would record changes in the brain waves that are characteristic of awakening. Sleep apnea results in low oxygen levels in the blood because the blockages prevent air from getting to the lungs. The low oxygen levels also affect brain and heart function. Up to two-thirds of the people who have sleep apnea are overweight. Sleep apnea alters our sleep cycle and stages of sleep. Some studies have linked altered sleep stages with a decrease in growth hormone, which plays a key role in body composition such as body fat, muscle, and abdominal fat. Researchers have found a possible link between sleep apnea and the development of diabetes and insulin resistance (the inability of the body to use insulin). Peripheral neuropathy, or damage to the nerves in the feet and legs, is another cause of sleep disruption. This nerve damage can c Continue reading >>

Impact Of Obstructive Sleep Apnoea On Type 2 Diabetes And Vice Versa

Impact Of Obstructive Sleep Apnoea On Type 2 Diabetes And Vice Versa

Impact of Obstructive Sleep Apnoea on Type 2 Diabetes and Vice Versa European Endocrinology, 2013;9(2):1079 DOI: Type 2 diabetes and obstructive sleep apnoea (OSA) are diseases with high prevalence and major public health impact. There is evidence that OSA is independently associated with alterations in glucose metabolism. Furthermore, OSA is a significant risk factor for the development of type 2 diabetes. Possible causes might be intermittent hypoxaemia and sleep fragmentation with increased oxidative stress and sympathetic activity, which are typical features of OSA. OSA might also be a reason for ineffective treatment of type 2 diabetes. There is further evidence that the treatment of OSA by continuous positive airway pressure (CPAP) therapy might improve glucose metabolism. On the other hand, there are also hints in the literature that type 2 diabetes might induce sleep apnoea, especially in patients with autonomic neuropathy, but that OSA also facilitates the development of neuropathy in terms of mutual interactions between OSA, type 2 diabetes and diabetic neuropathy. Based on the current scientific data, clinicians have to be aware of the relations between OSA and type 2 diabetes, both from the sleep medical and the diabetological point of view. Acknowledgements: Bogdan Tautz provided us with unpublished data concerning the prevalence of obstructive sleep apnoea in diabetic patients in his GPs surgery. Keywords: Type 2 diabetes, obstructive sleep apnoea, diabetic neuropathy, continuous positive airway pressure Disclosure: The authors have no conflicts of interest to declare. Received: May 21, 2013 Accepted July 30, 2013 Correspondence: Kurt Rasche, Direktor der Klinik fr Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, HELIOS Klinikum Wuppertal, Heusner Continue reading >>

Sufferers Of Both Type 2 Diabetes And Sleep Apnea Could Lose Eyesight Within Four Years

Sufferers Of Both Type 2 Diabetes And Sleep Apnea Could Lose Eyesight Within Four Years

Follow all of ScienceDaily's latest research news and top science headlines ! Sufferers of both Type 2 diabetes and sleep apnea could lose eyesight within four years Patients who suffer from both Type 2 diabetes and obstructive sleep apnea are at greater risk of developing a condition that leads to blindness within an average period of less than four years, new research has found. Research led by the University of Birmingham has discovered that patients who suffer from both Type 2 diabetes and obstructive sleep apnea are at greater risk of developing a condition that leads to blindness within an average period of less than four years. Obstructive sleep apnea (OSA) is a condition where the walls of the throat relax and narrow during sleep, resulting in snoring and interrupting breathing, and it is common in patients with Type 2 diabetes. Meanwhile, diabetic retinopathy -the most common form of diabetic eye disease -- affects between 40 and 50 per cent of patients with diabetes and is a leading cause of blindness in the Western world. Previous studies have shown a link between OSA and diabetic retinopathy. However, prior to this research led by the University of Birmingham, published in American Journal of Respiratory and Critical Care Medicine, there had been no published studies assessing the impact of OSA on the progression of diabetic retinopathy in patients with Type 2 diabetes. Corresponding Author Doctor Abd Tahrani, of the University of Birmingham's Institute of Metabolism and Systems Research, said: "Despite improvements in glucose, blood pressure and lipid levels, diabetic retinopathy remains very common. "Meanwhile, OSA has been shown to be very common in patients with Type 2 diabetes, which is not surprising considering that excess weight contributes to the d Continue reading >>

The Diabetes-sleep Apnea Link

The Diabetes-sleep Apnea Link

By Marianne Wait Maybe your bedmate has noticed that you snore loudly and stop breathing for seconds or even minutes at a time, and then start again with a loud snort or gasp. Or perhaps you’re inexplicably tired during the day despite getting a solid seven or eight hours of sleep. If this sounds like you, you may have sleep apnea. What is Sleep Apnea? People with sleep apnea stop breathing or have periods of very shallow breathing while sleeping, usually multiple times a night. It’s no wonder they wake up exhausted. The most common type of sleep apnea is obstructive sleep apnea, in which the airway collapses or becomes blocked during sleep. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. Central sleep apnea is less common. It occurs if the area of the brain that controls breathing fails to send the right signals to the breathing muscles. Symptoms of Sleep Apnea Most people who have sleep apnea don’t know they have it. Other signs and symptoms include morning headaches, dry mouth, or a sore throat; difficulty concentrating; irritability or depression; and waking up often to urinate. If your doctor suspects sleep apnea, he or she may refer you to a sleep specialist. That expert may prescribe a sleep study, either at home using portable monitors or in a sleep lab, to help make the diagnosis. How Diabetes and Sleep Apnea are Connected People with type 2 diabetes are at much higher than average risk for sleep apnea—and in a vicious cycle, having untreated sleep apnea can raise blood glucose levels. On the positive side, if you have type 2 diabetes and sleep apnea, treating your sleep apnea may help you manage your blood sugar levels and could even improve your insulin sensitivity, according to the American Academy of Sl Continue reading >>

Sleep Apnea In Type 2 Diabetes

Sleep Apnea In Type 2 Diabetes

IN BRIEF Obstructive sleep apnea (OSA) alters glucose metabolism, promotes insulin resistance, and is associated with development of type 2 diabetes. Obesity is a key moderator of the effect of OSA on type 2 diabetes. However, chronic exposure to intermittent hypoxia and other pathophysiological effects of OSA affect glucose metabolism directly, and treatment of OSA can improve glucose homeostasis. Insulin Resistance and β-Cell Dysfunction in OSA Mechanisms Figure 1 elucidates the biological pathways through which OSA leads to abnormal glucose homeostasis and the clinical conditions of prediabetes and type 2 diabetes. Intermittent hypoxia (IH) in animal models has been shown to decrease insulin sensitivity (measured via glucose tolerance test [GTT]) and increase the homeostatic model assessment (HOMA) index (7–9). IH affects hepatocytes directly, resulting in increased cellular glycogen content and gluconeogenic enzymatic activity (9). Prolonged periods of IH exposure in mice cause an increase in proinflammatory cytokines (interleukin-1β, interleukin-6, and macrophage inflammatory protein 2) and transcription factor nuclear factor-κB (10). Reduction in proliferation and apoptosis of pancreatic β-cells and reduced conversion of proinsulin to insulin has been observed in response to IH in mice (11–13). Adipose tissue is also affected by IH, with downregulation of adiponectin, an insulin-sensitizing hormone, and an increase in resistin (14,15). Finally, IH has been observed to be associated with sympathetic activation in both animal models and humans (16,17). Louis and Punjabi (18) studied healthy adults under conditions of normoxia and after 5 hours of IH exposure during wakefulness. IH was induced at a rate of 24 per hour, simulating moderate OSA. Intravenous GTT Continue reading >>

Diabetes And Sleep Apnea: How Sleep Affects Blood Glucose And Diabetes

Diabetes And Sleep Apnea: How Sleep Affects Blood Glucose And Diabetes

Treat Apnea to Control Diabetes? Sleep apnea can affect diabetes control in many ways. Struggling for air may put your body into fight-or-flight mode, releasing stress hormones that can raise blood glucose levels. If you're tired, you won't want to take that walk around the block after lunch. While you're at work, you might keep snacking to stay awake. But can treating sleep apnea lead to better blood glucose control? Arvind Cavale, M.D., an endocrinologist in Feasterville, Pennsylvania, refers about 60 percent of his patients with type 2 diabetes for sleep studies. Cavale says treating sleep apnea reduces insulin resistance, improves alertness and motivation, and leads to more stable blood glucose levels. "We use correction of sleep apnea as a tool in controlling diabetes," he says. Does This Sound Like You? This is not a happy scenario: You're soooo tired. As soon as your head hits the pillow, you're asleep. But a little while later, someone nudges you awake. You go back to sleep. Just as you get into a deep sleep, you're nudged again. Sleep ... nudge ... sleep ... nudge. All night long. The next day, you might wake up with a headache, snap at your family over breakfast, have trouble concentrating at work. Irritability. Car accidents. Depression. High blood pressure. All because of those nightmarish nudges throughout the night. If you have obstructive sleep apnea syndrome (OSA), you're getting those nudges. It's your body fighting for air. And sleep apnea may be one explanation for difficulty in controlling blood glucose and blood pressure levels. With OSA, something partly or completely blocks your airway when you're asleep. It could be your tongue. It could be the soft tissues in the back of your throat relaxing too much. Snoring is a sign that air is being forced p Continue reading >>

Diabetes And Sleep Apnea: Risks, Signs & Symptoms

Diabetes And Sleep Apnea: Risks, Signs & Symptoms

Diabetes and Sleep Apnea Ever hear of the saying “which came first, the chicken or the egg?” Well, sleep apnea and diabetes are like that. Do you find yourself tired during the day and reaching for that snack for some energy? Snacking leads to blood sugar spikes which can lead to Type 2 diabetes. If you have diabetes and are carrying a few extra pounds, you have an increased risk of developing sleep apnea. It is estimated that 40 percent of people who have obstructive sleep apnea (OSA) have diabetes. In people who have diabetes, the prevalence of OSA may be up to 23 percent, and diabetics who have some form of sleep-disordered breathing may be as high as 58 percent. How It All Adds Up A large, 16-year trial conducted by the University of Toronto studied sleep apnea persons and their potential risk of developing diabetes. It was found that people with severe sleep apnea were found to have a 30 percent higher risk of developing Type 2 diabetes than people without OSA. Those with mild or moderate OSA had a 23 percent increased risk of developing Type 2 diabetes compared to those without OSA. According to Dr. Ralph Pascualy, a sleep physician in Seattle, Washington, sleep apnea is a major contributor to the development of diabetes. Fifty percent of men with Type 2 diabetes have sleep apnea, compared to an estimated 4 percent of middle-aged men overall. Type 2 diabetes involves the processing of glucose. Our bodies use glucose as fuel to function properly. Glucose is a type of sugar, a component of many carbohydrates. The pancreas produces insulin which absorbs the glucose in the bloodstream. When the pancreas cannot produce enough insulin to absorb the glucose in the blood or the body cells cannot respond to the glucose in the bloodstream, diabetes develops. Higher bloo Continue reading >>

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