January 11, 2016

Diabetes and Sleep Apnea P1

This article from WebMD has several of our newer members asking questions that are serious. Two of the women are overweight and three of the men are well overweight. We do make an issue of this, but accept them as they are. When this showed up in their email on January 5, three of them were talking to Max and me about what they should be concerned about. Max and I both have obstructive sleep apnea and use a type of CPAP machine when we sleep.

All three were stating they were tired during the day and did not feel like they were getting enough sleep. Two said that even if they tried to get nine hours of sleep, they still felt sleepy during the day. All three said they often were fighting to stay awake during the day and have been warned about sleeping on the job.

Max said they probably had sleep apnea and needed to be tested and then follow what the doctor recommended. Max knew the local doctor that could help them and gave them the name and phone number. The next day they all had appointments and by Friday, they were scheduled for in home sleep studies.

Now they were asking more questions about how the studies were done and what the studies would show. Both Max and I said they should wait until they received the sleep study kits and instructions. I said I had never had a home sleep study and had always been in a sleep study lab and been hooked up to many sensors and had been observed while I slept. They asked how many times I had this. I said the insurance I had before age 65 required a sleep study and when I turned 65, Medicare also required a sleep study lab. They do not accept that I had sleep apnea and that is why they require it.

I said that 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 is measured in a sleep laboratory, technicians would record changes in the brain waves that are characteristic of awakening. In other words, you have been awakened out of REM sleep by the apnea and now must relax enough to reenter REM sleep.

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. 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 cause a loss of feeling in the feet or symptoms such as tingling, numbness, burning, and pain.

Now the three were very anxious and wondered if the sleep study was worth the effort. Max answered with an emphatic – YES and I said it is such a great feeling to not feel tired during the day. If there is a link to diabetes, since they already had diabetes, this should not affect their decision and using a CPAP machine should help with insulin resistance and possibly weight loss.

Max and I both stated that we had neuropathy and sleep apneas before we were diagnosed with diabetes and felt that we were better able to manage our diabetes by using the CPAP machine. We told them that the lack of sleep did make diabetes more difficult to manage. They wanted to talk more after the sleep study and after meeting with their doctor. Max and I agreed and said we could go with them to pick out the CPAP accessories.

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