Type 2 Diabetes and Sleep Apnea

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’s especially important for people with type 2 diabetes to recognize sleep apnea and have it treated.

Sleep Apnea: What Is It?

Sleep apnea is a sleep disorder in which people stop breathing many — sometimes hundreds — of times throughout the night, often for one minute or more. As a consequence, people with sleep apnea wake up several times each night, resulting in poor sleep and chronic tiredness. More than 12 million American adults are estimated to have sleep apnea, but most are undiagnosed. People with sleep apnea are at greater risk of having high blood pressure, heart disease, or a stroke.

The most common type of sleep apnea is obstructive sleep apnea, meaning that the airway is blocked or collapsed. Loud snoring results when air squeezes past the obstruction.

Type 2 Diabetes and Sleep Apnea: What’s the Connection?

People with type 2 diabetes are often obese and insulin resistant, and have large amounts of visceral fat — fat deep inside the body that 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 to also have sleep apnea.

Sleep Apnea: Symptoms

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
  • Mood swings
  • Difficulty controlling blood pressure and blood sugar levels

Sleep Apnea: Diagnosis

If you have these problems, you should talk to your doctor about your sleep patterns. He will ask you questions about your medical history and do a physical exam. He may even talk to your family members to find out how much you snore and if you choke when sleeping.

The next step is a sleep study to determine how well you sleep and for how long. Sleep studies can help your doctor identify any sleep problems and their severity. These studies are typically performed in a sleep lab, but there are now outpatient devices that your doctor can prescribe for you to use at home, under his supervision, to diagnose sleep apnea. Your doctor will then interpret the results. Home sleep evaluation is less expensive than going to a sleep lab, and insurance will usually cover it.

Sleep Apnea: Lifestyle Changes

If your sleep apnea is mild, making simple lifestyle changes might provide the relief you need. These include losing weight, which helps to keep your throat open by reducing the pressure on the neck from body fat, as well as avoiding alcohol and drugs that can lead to too much relaxation of the tongue, causing it to fall back and obstruct the airway. Quitting smoking and sleeping on your side rather than your back can also improve symptoms.

Sleep Apnea: CPAP

The most common treatment for moderate or severe sleep apnea is called continuous positive airway pressure (CPAP). You wear a mask-like device over your nose, and it blows air under pressure into your throat to keep your airway open. The air pressure is adjusted to be just enough to keep your throat from closing up or becoming blocked while you sleep.

CPAP may not be comfortable for all patients. Side effects include skin irritation on the face, dry eyes, stuffy or dry nose, and headaches. If you experience any of these, talk to your doctor about steps you can take to reduce them, including switching to another type of CPAP machine and mask. Once properly adjusted, CPAP usually makes people with severe sleep apnea feel much better.

Sleep Apnea: Surgery

Surgery to widen breathing passages is another treatment option for some people with sleep apnea. It generally involves stiffening, shrinking, or removing excess tissue in the throat or mouth, or even resetting your lower jaw. These techniques physically enlarge the airway, so it is less likely to collapse and obstruct air passages while you sleep.

If you have type 2 diabetes, there is a good chance you also have, or may develop, sleep apnea. Watch for symptoms and ask your loved ones if you snore or seem to stop breathing during the night. Once your sleep apnea is diagnosed and treated, you probably will see an improvement in your blood sugar levels, and you will be able to sleep more soundly.


Courtesy of: Everyday Health