Diabetes & Sleep Apnea: Everything You Need to Know

Sleep apnea is a much bigger problem than it is trusted, especially for people who live with diabetes.

Diagnosis without a proper overnight test is difficult, and if too many people struggle to breathe properly during sleep, they may not believe that they will not get enough oxygen every night.

However, sleep apnea can affect many aspects of daily life and overall health. And the link to diabetes is indisputable.

This article discusses sleep apnea, common causes and symptoms, the relationship between type 1 and type 2 diabetes, and the best treatment options today.

What is sleep apnea?

Sleep apnea (also known as “obstructive sleep apnea” or “OSA”) is a condition defined by a long pause during breathing during sleep. According to the National Sleep Foundation, breathing pauses must be at least 10 seconds longer to qualify.

A pause in breathing is when the muscles behind the throat are partially closed or cannot be left open for various periods of time during sleep.

The reason these breathing pauses are both worrying and troublesome is that they can lead to a variety of other issues, as they can cause a serious lack of oxygen in the blood.

Unprocessed sleep apnea results

Daytime fatigue and fog
Hypertension
Heart arrhythmia
Congestive heart failure
Heart attack
stroke
Depression and mood problems
Memory issues
Insulin resistance
Increased risk of type 2 diabetes
Drunk driving

OSA and children can develop, but it is less common.

Causes of sleep apnea

Anyone can develop sleep apnea, but the following are properties or habits that increase your risk of developing a condition:

Obesity: Approximately 2/3 people with OSA are overweight or obese
OSA or Snoring Family History
Abnormally small mandible or other abnormal facial features
A dented chin
Being a man: Much more people with OSA are male vs. female
Smoking a cigarette
Big neck circumference
Big tonsils
Drink alcohol before bed
Postmenopausal (for women)
Hypothyroidism (low levels of thyroid hormone)
Terminal gully (high levels of growth hormone)
Over 40 years old
Being an African American, Pacific Island, or Hispanic

There is another type of sleep apnea that is caused by your brain’s inability to manage normal breathing, but that type is rare.

The type most commonly experienced by the general population is obstructive sleep apnea, which affects approximately 18 million people in the United States.

Symptoms

The signs and symptoms of sleep apnea are often easier to dismiss or easily mistaken for individual problems, rather than many symptoms associated with the same condition.

The National Sleep Foundation lists the following common signs and symptoms of sleep apnea:

Chronic snoring
I’m always feeling sleep deprived
It’s difficult to concentrate
depression
I’m irritated
Sexual dysfunction
Difficulty in learning and memory
Falling asleep during normal daytime activities
Sleeping hindrance

If you are a chronic snore or suspect that any of these symptoms may be present in your life regularly, talk to your primary care physician about scheduling with a sleep expert who can assess sleep apnea.

Studies have demonstrated again and again that OSA and diabetes have an undeniable relationship and are often seen in the same patient.

Let’s take a look at some of the most important studies.

Sleep apnea raises blood sugar levels

This 2016 study from the American Diabetes Association found that OSA alters oxidative stress, inflammation, neuroendocrine dysregulation, and glucose homeostasis.

The findings in this study encourage healthcare professionals to assess all patients with type 2 diabetes for potential signs of sleep apnea and vice versa.

“Early recognition and intervention of OSA can be expected to improve insulin sensitivity and control of hyperglycemia in many patients. Clinicians should monitor signs and symptoms of OSA and CPAP compliance, as well as weight management, dietary control, and medication compliance in patients with type 2 diabetes.”

Sleep apnea associated with insulin resistance and type 2 diabetes

This 2018 report on OSA evaluated dozens of studies on the meaning and connections between conditions and other conditions.

It was determined that OSA patients are at increased risk for developing hypertension, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, dyslipidemia, and atherosclerosis.

Sleep apnea increases the risk of type 2 diabetes

This 2017 study from Taiwan determined that OSA patients were much more likely to develop type 2 diabetes. In contrast, this study determined that type 2 diabetes patients are not necessarily more likely to develop OSA.

This means that OSA appears to be a precursor to the onset of type 2 diabetes, but type 2 diabetes is not a precursor to developing OSA in patients who have not yet developed this sleep state.

A 2018 survey from Japan reflected similar survey results.

“While OSA patients are more likely than non-OSA populations to develop type 2 diabetes, more than half of those suffering from OSA.”

Treating OSA with CPAP improves insulin resistance

The CPAP device, which represents “continuous airway pressure,” is the primary treatment method for OSA, and this 2018 study from Japan found that consistent use of CPAP improves the level of insulin resistance in patients.

“CPAP improved glucose metabolism as determined by oral tolerance testing in OSA patients. Several studies have shown that CPAP improves insulin resistance, particularly in obese populations undergoing long-term CPAP.”

This is important in terms of treating patients with both OSA and type 2 diabetes. By treating OSA, patients may also see relief to moderate improvements from improved blood sugar levels and overall diabetes health.

Both type 2 diabetes and OSA increase the risk of cardiovascular disease

“Because both diabetes and OSA lead to cardiovascular disease, clinicians and medical professionals need to be aware of the association between diabetes and OSA,” explains the same 2018 study from Japan.

This study suggests that healthcare professionals should consider using CPAP devices to treat patients with type 2 diabetes and/or OSA.

OSA increases the risk of STDR (diabetic retinopathy that threatens vision)

A 2017 study from the UK found that patients with type 2 diabetes and those with existing diabetic retinopathy had a significantly increased risk of developing proliferative diabetic retinopathy, defined by the patient’s worsening vision.

Treating OSA using CPAP devices reduced the progression of STDR in these patients, but it was determined that further research is needed to concentrate more on the benefits of treating OSA to inadvertently treat STDR.

Patients with type 1 diabetes are at increased risk for OSA

“The prevalence of asymptomatic OSA is high in a cohort of type 1 diabetes,” the 2017 study from Denmark has been decided.

Other risk factors for the type 1 diabetes population include existing and existing diagnoses of nephropathy (renal disease).

“OSA was present in 32% of patients with normal BMI, 60% of patients with overweight, and 61% of patients with obese,” the study explains.

Furthermore, this study found that patients with type 1 diabetes and OSA rarely report symptoms, particularly drowsiness compared to patients without OSA. This makes catching, diagnosis and treatment difficult.

Health professionals treating type 1 diabetes patients should note that if they are overweight and suffer from nephropathy, this population should be potentially screened for OSA.

Treatment Options

If you think you may have sleep apnea, the first place to start asking for help is through your primary care doctor.

Perhaps if you share your bed with your partner, you won’t be in the news that you’ll have a terrible, snoring and destructive snoring. You may want to set up your phone to record your own snoring sounds. This alone could reveal a long gap in the rhythm of breathing or inconsistent snoring.

After that, doctors are advised to take part in sleep studies. In other words, you will stay at a “sleep centre” overnight and have your breath monitored all night.

It also monitors eye movements, muscle activity, heart rate, breathing effort, airflow and oxygen levels in the blood.

This allows healthcare teams to clearly understand whether they have sleep apnea and how serious sleep apnea is based on whether they have sleep apnea and how little sleep apnea is during sleep.

As mentioned before, the biggest treatment for sleep apnea is the CPAP device.

CPAP looks more uncomfortable than it actually is. This can discourage patients from pursuing treatment in the first place.

CPAP is a mask that fits over your mouth or nose, and blows air into your airways to keep them open properly during sleep.

Research has shown that it is the most effective treatment for sleep apnea, but one difficult aspect of this method is to let patients use it consistently.

The device itself also brings light and soft noise when powered on. This is similar to the sound of sound. Ideally, the sound itself does not interfere with sleep and could improve sleep by providing white noise.

What else can you do to treat sleep apnea? Let’s take a look at all the options recommended by the National Sleep Foundation.

Continuous Positive Airway Pressure (CPAP) Device: A mask that covers the mouth and nose and provides air that helps keep the airways open while sleeping.
Oral Pressure Therapy (OPT): Similar to CPAP devices, but with no mask, this treatment is a mouthpiece that delivers air to keep your throat open properly while you sleep.
Positive airway pressure (EPAP) with a call: The device covers the nostrils and a disposable adhesive valve that keeps the airway open.
Dental instruments Repositioning the jaw and tongue
Upper airway surgery to remove excess tissue: If you have anatomical facial abnormalities, it can be corrected surgically and keep your jaw and throat open properly during sleep.
Lose weight: Weight loss can have a major impact on sleep apnea. If you are reluctant to use your device, make sleep the necessary motivation to lose weight.
Avoid, reduce or limit alcohol intake
Stop smoking
Sleep on the side, not on your back