Diabetes and Sleep Apnea: A Dangerous Duo

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South Shore Health

The Center for Disease Control (CDC) calls insufficient sleep a public health epidemic. While a huge portion of this mass sleeplessness can be blamed on society’s 24/7 pace, you can also blame these sleep-deprived nights on a disorder known as sleep apnea.

Obstructive sleep apnea (OSA) is a condition that occurs when a person stops breathing during sleep for 10 seconds or more, sometimes hundreds of times a night, because of obstructed sleep airways. When the body doesn’t have enough air flowing into the lungs or if the airway is partially or fully blocked during sleep, the result is often loud snoring and a drop in blood oxygen level. If the oxygen drops to a dangerous level, it triggers the brain to disturb sleep. Normal breathing then starts again usually with a loud snort or choking sound. More than 20 million Americans suffer from the disorder and almost 90 percent of people who have sleep apnea are undiagnosed.

For people who have diabetes, poor sleep habits—including difficulty falling and staying asleep—are all too common. When you add sleep apnea to the mix, both conditions become far more difficult to control.

Which Came First—Sleep Apnea or Diabetes?
It is estimated that 40 percent of people who have OSA have diabetes. Both medical conditions share common risk factors and each condition affects the other. The devastating effects of each make the risks of diabetes and sleep apnea a dangerous combo.

Because Type 2 diabetes affects the way the body metabolizes glucose—its most important source of fuel—when the body’s cells are denied oxygen brought on by sleep apnea, the person’s body goes into the “fight or flight” mode. In this emergency mode, stress hormones are released into the bloodstream to compensate for the lack of oxygen. The hormones not only release more glucose into the blood, but also raise heart rate and increase a person's risk for high blood pressure, heart attack, stroke, arrhythmias, and even heart failure. Over time, this rise in blood sugar levels increases the insulin resistance in the body, worsening diabetes.

Since the early 1980s, researchers have found independent associations between sleep apnea, glucose intolerance and insulin resistance—a well-known risk factor for diabetes. The complicated question becomes: Can one cause the other?

“Obstructive sleep apnea is associated with metabolic disturbances,” said Linda Murphy, R.EEGT, R.PSGT, RST, CSE, supervisor of Neurosensory Diagnostics at South Shore Health. “Left untreated, OSA can lead to changes in how your body uses energy. These changes increase your risk for obesity and diabetes.”

What Now?
Seeking proper medical treatment for diabetes and sleep apnea will vastly improve your quality of life. Research has shown that diagnosing OSA in diabetics could help with effective treatment of both conditions. While treatment for sleep apnea will give you the oxygen you need during sleep for your body to do its proper restoring and repairing of tissue and functions, adhering to diabetes treatment may also reduce some of the factors worsening sleep apnea. For those individuals who have been found to be pre-diabetic, studies have shown that being treated for sleep apnea can improve blood sugar levels and reduce the risk for diabetes.

If you have diabetes and suspect you may have sleep apnea, talk to your primary care provider or a sleep physician about getting a sleep assessment at South Shore Hospital's Sleep Center. Patients of South Shore Medical Center who qualify based on previous medical conditions and/or insurance authorization may be eligible for a home sleep study. Learn More.