The last thing your diabetic patients need is another complication that increases their risk for comorbidity or further complications.

Untreated obstructive sleep apnea (OSA) can lead to serious consequences and further complications for your diabetic patients. OSA makes controlling blood sugar more difficult. In patients with obstructive sleep apnea repeated airway closure triggers a flight or fright response, which produces a high level of cortisol. Elevated levels of cortisol have been associated with insulin resistance and glucose intolerance. Frequent drops in oxygen levels causing stress at the cellular level also likely explain why blood sugars may be harder to control.

Other complications of the sleep disorder include:

• Cardiovascular disease (hypertension, heart attack, stroke, A-Fib, endothelial dysfunction…)
• Depression
• Decreased libido
• Neurocognitive deficit (daytime hypersomnolence, irritability, memory decrement, decreased productivity at work…)
• Socially unacceptable snoring
• Accidents and injury in the workplace and on the highwa

Diabetic patients are more likely to be overweight, which increases their likelihood of suffering from OSA. As a person gains weight, the excess fat accumulates in the soft tissues and neck potentially narrowing the airway. This is why the risk for sleep disordered breathing increases even more so with overweight and obese individuals.

So how can Endocrinologists such as yourself help?

A widely quoted British study reported 23% of type 2 diabetics have sleep apnea and more recent studies (such as the study results from ResMed cited below) have shown even higher numbers. The International Diabetes Federation Taskforce on Epidemiology and Prevention strongly recommends that health professionals working in both type 2 diabetes and SDB adopt clinical practices to ensure that a patient presenting with one condition is considered for the other.

It is estimated that 80% of Americans who suffer from sleep apnea remain undiagnosed. In order to combat this sleep condition that affects more than 20 million unaware Americans, health care practitioners such as yourself must remember to keep sleep health at the forefront during patient interaction.

This blog was co-written by Dr. Rogers, DMD, DABDSM, and Dr. Bijwadia, MD.