In a recently published study in the American Journal of Respiratory and Critical Care Medicine, researchers have concluded that there appears to be a confirmed link between sleep apnea and the risk of developing diabetes. The study published in the online edition of the journal on June 6, confirms that the risk of developing diabetes is increased by more than 30 percent with the occurrence of severe obstructive sleep apnea (OSA). The confirmation of the link gives hope to medical care practitioners, who can adopt preventative measures with patients who have obstructive sleep apnea, but have not yet developed diabetic conditions.
The author of the study led by Dr.Tetyana Kendzerska, from the University of Toronto’s Institute of Health Policy, Evaluation and Management, analyzed health data of 8678 adults who were tested for OSA. The data of the test population, with a median age of 48 years, and 62 percent being male, extended for seven years from between 1994 to May of 2011. Almost 12 percent of the study group developed diabetes during the 67 months of follow-up, and the incidence of severe OSA was heavily correlated with the occurrence of diabetes with a cumulative incident rate of almost 17 percent.
Sleep apnea is a condition that can disrupt sleeping patterns, and there are different levels of severity. The condition is difficult to diagnose, and there may be multiple causes. In OSA, the airways may collapse or become blocked, leading to ineffective or shallow breathing.
During the study that confirmed the link between sleep apnea and the risk of developing diabetes, all OSA-related variables, such as REM sleep, sleep and awakening times, heart rates and oxygen saturation were monitored. The data was analyzed to include adjustments for sex, age, body mass index (BMI), waist measurement and the self-admitted use of alcohol and tobacco. Other factors that were used to predict the risk of developing OSA-related diabetes include the circumference of the neck, which has been linked to insulin resistance, sleepiness during the daytime, lack of sleep, and heart rate, which is monitored during sleep.
For a correlation of the data, an apnea index with ranges from five to more than 30 was developed. The index was based on the number of complete apneas and partial apneas. The obstructive sleep apnea was considered mild if the range was less than 15, while moderate OSA ranged from 15 to 30, and all ranges exceeding 30 were considered as severe. The study has led to a better understanding of the mechanisms that lead to diabetes, such as sleep deprivation, and low oxygen levels that lead to stress.
The authors confirm that there were some limitations on the conclusion drawn from the study as the missing data, such as the family history of diabetes, race and background, and the inability to classify the type of diabetes may affect the results. However, given the age of the population, the majority of the contractions can be expected to be Type 2 diabetes, as Type 1 tends to occur in the younger population such as children and adolescents.
Previous research has established that links exist between obstructive sleep apnea, and the risk of developing diabetes, but the extensive study, that includes data of more than 8000 patients, and with a follow-up period that covered 67 months, the researchers hope that many limitations have been overcome. It is also hoped that the risk predictors can be used to develop preventative interventions.
By Dale Davidson