The Link Between Sleep Apnea and Diabetes
Mounting scientific studies demonstrate that inadequate sleep disrupts the body’s capacity to reduce insulin, sparking the onset of diabetes. Additionally, poor sleep can decrease metabolism and increase the body’s concentration of the stress hormone cortisol. Cortisol can be a two-edged blade, causing an increase in appetite and a reduction in calorie burning capacity. The end result is weight gain.
The need to get enough sleep does not decline with age. Adults, regardless of age, usually require seven to nine hours of sleep each night.
Older individuals may need fewer hours of sleep each night, but that’s only because they wake more often. They often make up for what they don’t receive at night with daytime naps. But sleepers, young or old, should be aware of snoring, since it often signals sleep apnea. This is a sleep disorder that often results in other serious medical complications.
With sleep apnea, a person regularly stops breathing or breathes only minimally throughout the night. The resulting oxygen deprivation can put excess burden on the heart and arteries, culminating in serious cardiovascular disease if left untreated. Frequent and regular snoring is regularly associated with high blood pressure. And achieving less than adequate sleep can wreak havoc on growth hormone secretion, which is also associated with obesity. As the secretion of growth hormone dwindles, the body tends to put on pounds.
An additional study conducted by researchers at the University of Chicago has found obstructive sleep apnea can negatively affect glucose control in patients with type 2 diabetes. The study found that there is a clear, graded, inverse relationship between the severity of sleep apnea and glucose control. The study also confirmed that undiagnosed sleep apnea is very common amongst type 2 diabetes patients. This indicates that it is a largely unrecognized additional risk factor for these patients.
Dr. Renee Aronsohn and her colleagues recruited a number of patients with type 2 diabetes from outpatient clinics to participate in the study. The participants were interviewed to assess diabetes history, medical history and medications, and level of physical activity. Each patient also had height and weight measurements taken and each participant had their sleep/wake cycles closely monitored for five days. Finally, participants underwent polysomnography testing for sleep apnea, and their glucose control was assessed by obtaining a blood sample for hemoglobin measurement.
The researchers discovered that more severe obstructive sleep apnea was associated with reduced glucose control, suggesting a role in more severe cases of diabetes with additional potential medical complications. In comparison to patients without sleep apnea, the presence of mild, moderate, or severe sleep apnea greatly increased hemoglobin measurement values by 1.49, 1.93, and 3.69 respectively. These effect sizes are comparable to widely used hypoglycemic medications, indicating that having obstructive sleep apnea may actually negate the beneficial effects of these anti-diabetic drugs.
Dr. Aronsohn claims that these findings have significant clinical implications since they indicate that reducing the severity of sleep apnea may improve glycemic control. In conclusion, effectively treating obstructive sleep apnea may be a novel and non-pharmacologic intervention in the treatment of type 2 diabetes.