April 23, 2015

Diabetes and Sleep Apnea

I have written more than the one below on sleep apnea, but this is mainly concerning sleep apnea and management of blood glucose.

The sad part is many people with sleep apnea do not realize that they are at risk for diabetes and a slightly a smaller percentage of those with diabetes are at risk for sleep apnea. Even then, people will not listen when they have one condition and you warn them about the risk for the other.

Sleep apnea and understanding that it affects blood glucose management negatively is important. I am fortunate that I have no problems using my sleep apnea equipment, as I obtain the sleep I need and sleep apnea is not a factor in the management of my blood glucose levels. I have a few acquaintances and a few more friends that ignore their sleep apnea and laugh at me when I bring the following into the discussion.

Some of the reasons people refuse to use their sleep apnea equipment include:
  1. Vanity – they don't feel sexy or manly wearing the mask
  2. Some feel wearing the mask is claustrophobic
  3. Some do not like the lines that the mask straps cause in their skin because they have the straps too tight
  4. Many complain about the noise the machine makes
  5. Many have a problem with the air leaks around the mask because they aren't properly fitted or having a mask that fits properly
  6. Many people do not understand that not getting the sleep they need will contribute to the development of diabetes or make diabetes more difficult to manage.

Severe obstructive sleep apnea (OSA) may increase a person's risk of developing diabetes by 30% or greater. This is according to an article published online June 6, 2014 in the American Journal of Respiratory and Critical Care Medicine.

Of the 8678, patients who underwent the sleep study, 1017 (11.7%) developed diabetes during a median of 67 months of follow-up, which translates to a cumulative incidence of 9.1% at 5 years. Incidence came to 7.5% for patients with mild OSA, 9.9% for moderate OSA, and 14.9% for severe OSA. Limitations of the study include missing data on some potential confounders, such as race and family history of diabetes and the inability to categorize diabetes as type 1 or type 2.

Another author wrote, a man over age 65 with type 2 diabetes has a 67 percent chance of having sleep apnea; for older women, the chance is almost 50 percent. Besides making it difficult to get a good night’s sleep, sleep apnea increases stress on the body, causing blood sugar levels to rise. So it is especially important for people with type 2 diabetes to recognize sleep apnea and have it treated.

People with type 2 diabetes are often obese and insulin resistant, and have large amounts of visceral fat, fat deep inside the body that is covering and surrounding their organs. What causes sleep apnea isn’t entirely known, but there appears to be a connection between insulin resistance, obesity, especially with visceral fat and a big waistline, and sleep apnea. This makes obese people with visceral fat and type 2 diabetes more likely also to have sleep apnea.

The most common symptom of obstructive sleep apnea is loud, persistent snoring, which may include pauses followed by gasping or choking. (Keep in mind that not all snorers have sleep apnea.) Other symptoms include:
  • Chronic fatigue (for example, you may fall asleep while driving or during inactive times throughout the day)
  • Problems concentrating (inability to complete simple tasks)
  • Mood swings (happy one minute and unhappy the next)
  • Difficulty controlling blood pressure and blood sugar levels

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