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The Diabetes-Sleep Apnea Link

Find out why these conditions often go hand in hand—and how to take back your zzzs.


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.

Most people who have sleep apnea don’t know they have it. Other signs and symptoms include morning headaches, dry mouth, or 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.

The Diabetes Connection

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 Sleep Medicine.

What’s the link between sleep apnea and blood sugar? There are probably several. Obesity is one common cause of both obstructive sleep apnea and diabetes.

The other possible links are complicated. Research suggests that the lack of oxygen to the tissues that occurs when breathing stops may be part of it. This oxygen deprivation may alter glucose metabolism, cause oxidative stress (in which cells are harmed or die), and over-activate the sympathetic nervous system, the part that’s in charge of the “fight or flight” response. It’s known that oxidative stress and sympathetic nervous system over-activation may increase the risk of diabetes.

How is sleep apnea treated?

If you have type 2 diabetes and you’re obese, there’s a chance that losing weight will significantly improve your sleep apnea or even put it in remission.

Avoiding alcohol, stopping smoking, and losing weight can help with sleep apnea in some people.

If your sleep apnea is mild, a mouthpiece that adjusts the lower jaw and tongue to help keep the airway open at night may be one treatment option. A dentist or orthodontist can make a custom one for you.

A continuous positive airway pressure (CPAP) machine is the most common treatment for sleep apnea. A CPAP machine involves a mask you wear on your face and uses mild air pressure to keep your airway open while you sleep. It can take a while to adjust to using a CPAP, and some people find them unwieldy and uncomfortable. Tell your doctor if you’re not happy with the type you’re using. He or she may suggest switching to a different type. There are many types of CPAP machines and masks. As incentive, note that using a CPAP machine has been shown to improve A1C levels in people with type 2 diabetes as well as obstructive sleep apnea over time.

Some people who have sleep apnea may benefit from surgery to widen their breathing passages. The kind of surgery used and how well it works depend on the cause of the sleep apnea. Surgery usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.

Bottom line: Sleep apnea is a serious condition, but very treatable. So don’t just stick ear plugs in and ignore the buzz saw going on at night. Get it checked out.

Marianne Wait is a writer and editor who specializes in health and wellness. She conceived and created the Reader’s Digest books Magic Foods for Better Blood Sugar and Stopping Diabetes in Its Tracks, among others. Her work has appeared in media outlets ranging from WebMD to Arthritis Today to Parade

SOURCES

National Heart, Lung, and Blood Institute. “What Is Sleep Apnea” Accessed 3/28/17.https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea

Gary D. Foster, PhD; Kelley E. Borradaile, PhD; Mark H. Sanders, MD; et al. “A Randomized Study on the Effect of Weight Loss on Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes.” Arch Intern Med. September 28, 2009. http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/224770

American Academy of Sleep Medicine. “Patients with Type 2 Diabetes or Hypertension Must Be Evaluated for Sleep Apnea.” June 3, 2013. http://www.aasmnet.org/articles.aspx?id=3935

Martínez-Cerón E, Barquiel B, Bezos AM, Casitas R, Galera R, García-Benito C, Hernanz A, Alonso-Fernández A, Garcia-Rio F. “Effect of CPAP on glycemic control in patients with obstructive sleep apnea and type 2 diabetes: A randomized clinical trial.” American Journal of Respiratory and Critical Care Medicine. August 15, 2016. doi: 10.1164/rccm.201510-1942OC. https://www.ncbi.nlm.nih.gov/pubmed/?term=26910598

Tasali E, Mokhlesi B, Van Cauter E. “Obstructive sleep apnea and type 2 diabetes: interacting epidemics.” Chest. February 2008. doi: 10.1378/chest.07-0828. https://www.ncbi.nlm.nih.gov/pubmed/18252916

Alicia A. Thorp and Markus P. Schlaich. “Relevance of Sympathetic Nervous System Activation in Obesity and Metabolic Syndrome.” Journal of Diabetes Research. Volume 2015. https://www.hindawi.com/journals/jdr/2015/341583/

Medscape Medical News. “Sleep Apnea-Diabetes Link Confirmed in Large Study.” June 09, 2014. http://www.medscape.com/viewarticle/826457

The Diabetes-Sleep Apnea Link
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Last modified: April 9, 2017

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