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Perspectives

Diabetes and sleep apnoea: common bedfellows

Lili Huo, Jonathan Shaw

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Abstract

Diabetes and sleep apnoea share several risk factors, including advancing age, obesity, hypertension and impaired glucose tolerance. The two conditions commonly coexist and may interact synergistically to increase the risk of cardiovascular disease. Heightened awareness of the need to consider screening for sleep apnoea in people with diabetes and also for diabetes in people with sleep apnoea is necessary.

Key Points

  • Sleep apnoea is a significant health problem in the general community, especially in people with diabetes.
  • Sleep apnoea is associated with insulin resistance, glucose intolerance and diabetes, independently of obesity.
  • The prevalence of sleep apnoea in patients with diabetes and obesity has been reported to be as high as 86%.
  • Intermittent hypoxaemia and fragmented sleep in patients with sleep apnoea trigger a wide range of pathophysiological mechanisms that may aggravate insulin resistance and glucose metabolism. Diabetes may contribute to sleep apnoea via neuropathy and weight gain related to medication use.
  • Treatment of sleep apnoea is associated with improvements in daytime sleepiness and quality of life, and may also have a favourable impact on glycaemic control.
  • Given the high prevalence of sleep apnoea and diabetes, and their strong associations with each other, the presence of one condition should actively prompt screening for the other, especially in the setting of obesity.

    Picture credit: © iStockphoto/Monkey Business Images. Model used for illustrative purposes only.

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