January 21, 2015

Study: Sleep Apnea Could Increase Risk Of Diabetes


A study released last year indicated that sleep apnea could increase the risk of getting diabetes by up to 30%. It’s important to note that the observational study of sleep apnea and diabetes is ongoing. There are no definitive answers as of yet that prove conclusively that sleep apnea patients will develop diabetes.

However, the links are there and show that there is some sort of observable, scientific connection. Now, is this connection or correlation? In this post, we’ll discuss both sleep apnea and diabetes as well as the study that has continued this discussion.

Sleep Apnea

Sleep apnea patients frequently experience periodic gasping or snorting noises, during which they may stop breathing momentarily up to 50 times or more per night. People with sleep apnea experience excessive daytime sleepiness and drowsiness. A person can get a full nights sleep but wake up tired and groggy because of an inadequate lack of air intake. Regular interruption of breathing and the obstruction of the breathing airways can pose serious health complications. A person who suspects they may have sleep apnea should seek a health care provider immediately.

National Institutes of Health

Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing pauses can last from a few seconds to a couple of minutes, this may occur 30 times or more an hour.

The most common type is obstructive sleep apnea. It causes your airways to collapse or become blocked during sleep. Normal breathing starts again with a snort or choking sound. People with sleep apnea often snore loudly. However, not everyone who snores has sleep apnea.

You are more at risk for sleep apnea if you are overweight, male, or have a family history of this disorder. Children with enlarged tonsils may also be more susceptible.

Doctors can diagnose sleep apnea based on the following factors: medical family history, a physical exam, and the results of an individual sleep study.

When your sleep is interrupted throughout the night, you can be drowsy during the day. People with sleep apnea are at higher risk for car crashes, work-related accidents, and other medical problems. If you have this disorder it is important to get treatment. Lifestyle changes, mouthpieces, surgery, and breathing devices can treat sleep apnea in many people. – NIH: National Heart, Lung, and Blood Institute

According to the Public Health Agency of Canada, there are an estimated 858,900 Canadian adults 18 and older who reported they have sleep apnea.

  • 3% of adults aged 18 years old and older
  • 5% of adults 45 years and older
  • adult men have a rate double that of adult women
  • 25% of adults reporting sleep apnea rated their health as fair to poor compared to 11% of the general population

The Public Health Agency of Canada funded the 2009 Canadian Community Health Survey. This survey conducted by Statistics Canada interviewed 9,523 Canadians 12 years and older. Sleep apnea patients were found to be 2.5 times more likely to report diabetic concerns.

Diabetes

Type 1 diabetes also known as juvenile diabetes is usually diagnosed in children and young adults. People with type 1 diabetes do not produce enough insulin, a hormone that converts sugar into energy needed for daily life activities. A physician will prescribe insulin therapy to help a person deal with this disease. People can lead healthy lives with a proper health regimen.

Diabetes is when a persons blood glucose sugar levels rise higher than normal. People with Type 2 diabetes do not produce enough insulin. The pancreas produces insulin that controls your blood sugar levels. Excess blood glucose levels may damage your eyes, kidneys, nerves and heart.

Patients who have sleep apnea are vulnerable to Type 2 diabetes. Adult males who are obese, or smokers are often at risk for developing this sleep disorder.

A few people are able to control type 2 diabetes with a change in diet and exercise. A doctor may have to prescribe oral medications or insulin injections to control their blood glucose levels. Certain racial groups are more susceptible to diabetes, afro americans, latinos, native americans, pacific islanders and asian americans are all at risk.

A Public Health Agency of Canada published a 2011 Diabetes in Canada study. Details from the study revealed the following:

  • 36.5% of Canadian adults reported having two or more other serious chronic conditions in addition to diabetes
  • 40% of Canadian adults reported their health as fair or poor compared to the majority of the general population
  • 3.1% of all Canadian deaths were attributed to diabetes in 2007

Diabetes and Sleep Apnea Connection

The largest study to date linking sleep apnea and diabetes of more than 8,500 patients confirms earlier evidence from shorter follow up periods. Dr. Richard Leung an assistant professor of medicine at the University of Toronto and director at the sleep laboratory at Saint Michael’s Hospital Richard Leon conducted a study on this topic. There has been a plethora of similar smaller studies over the years but never to the extent of Dr. Leung’s study.

The sleep apnea and diabetes link has never been proven as conclusive in studies done in the past. The magnitude of Dr. Leung’s study dwarfs previous sleep apnea and diabetic smaller studies from the past. Sleep apnea is most often associated with obesity in men on a larger number average of cases. People with diabetes are often at risk for obesity and vice versa. The large study conducted by Doctor Richard Leung took into consideration factors like obesity, historia cardiac disease, age, sex, socioeconomic status and if a person smoke or not. All factors in the study were controlled statistically, making this a first time ever break through study.

Dr. Leung and his research team still found a 30% high correlation between severe sleep apnea and patients developing diabetes during the follow up period of 10 years. This study showed a clear indication of causation. This observational study is the most accurate to date when it comes to the mechanisms applicable to the group in question. A longitudinal study that spans 10 years is not definitive in proving that sleep apnea leads to diabetes. Future studies will be able to prove without a doubt if sleep apnea is the main culprit for type 2 diabetes.

There is enough accumulative evidence today that patients who have newly diagnosed type 2 diabetes should also be screened for sleep apnea. Family history and the evidence of obesity are strong indicators for people at risk.- summary excerpt from interview fromSleepBetter.tv

Richard Leung, MD, PhD, Assistant Professor of Medicine at the University of Toronto and the Director of the Sleep Laboratory at St. Michael’s H

Sleep Apnea Symptoms

  • daytime sleepiness
  • loud snoring followed by silent pauses
  • gasping or choking during sleep
  • morning headache
  • irritability or mood changes
  • poor concentration or memory loss
  • lowered sex drive
  • falling asleep while driving
  • high blood pressure
  • stroke
  • heart attack
  • motor vehicle collisions
  • depression
  • decreased sexual function
  • work-related injuries

Data provided by Public Health Agency of Canada

Conclusion

Physicians should be aware that symptoms for sleep apnea may go hand in hand with the development of Type 2 diabetes. Diet, exercise and weight loss have been shown effective in dealing with sleep apnea. CPAP therapy is an option – but there are alternatives to CPAP. If you suspect you have sleep apnea come see us. We are here to help.

About Dr. Michael Layton

Dr. Michael Layton - South Surrey DentistDr. Michael Layton is a graduate of University of Washington Doctor of Dental Surgery program and completed his orthodontic residency in 2009. He enjoys providing the highest standard of ideal dentistry across multiple disciplines, including dental sleep medicine. You can follow him on Google+ or ‘Like’ Peace Arch Dental Centre on Facebook.