Sleep apnea and T2DM are conditions that share a bidirectional relationship. The complex interplay between the two means that sleep apnea can negatively impact glucose levels in those living with T2DM.

Sleep apnea is a sleep disorder characterized by interrupted breathing during sleep, leading to brief awakenings.

The most common type is obstructive sleep apnea where the walls of the airway relax and narrow during sleep, causing a person to briefly stop breathing.

Type 2 diabetes mellitus (T2DM) is a chronic condition that results from issues with how the body uses or produces insulin. These problems often result in high blood sugar levels, which can lead to health complications.

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Research suggests that the relationship between sleep apnea and T2DM is bidirectional. This term means that both conditions influence the development and progression of the other. Older research suggests that 71 in 100 people living with T2DM also experience obstructive sleep apnea.

One reason why sleep apnea is more common in those living with T2DM is that they both share obesity as a major risk factor. Excess fat around the neck can impair the tissue around the airway, which can lead to apnea. Also, the more excess weight a person has, the more resistant cells become to insulin.

Another potential reason that sleep apnea may be common in those living with T2DM is due to diabetes affecting respiratory control — it can therefore promote obstructive sleep apnea.

The relationship between sleep apnea and blood sugar levels is intricate. Sleep apnea may exacerbate insulin resistance. As such, this can lead to elevated blood sugar levels in individuals living with T2DM.

When experiencing sleep apnea, the body becomes deprived of oxygen. This in turn increases the amount of carbon dioxide in the blood. This can cause insulin resistance to increase, leading to hyperglycemia, or higher blood sugar levels.

Sleep apnea can also cause a person to experience disrupted sleep, which can also impact blood sugar levels. For example, waking up in the night, or a lack of consistent sleep, may cause an increase in insulin resistance and decrease in glucose tolerance.

Accurate diagnosis of both sleep apnea and T2DM is crucial for effective management.

To diagnose sleep apnea, a healthcare professional may recommend a sleep study. This can involve recording brain waves, monitoring heart rate, breathing, and a person’s oxygen levels in the blood. A doctor may also recommend keeping a sleep diary to self-record the quantity and quality of sleep

For T2DM, diagnosis involves one or a combination of tests. These may include blood tests to measure fasting blood glucose levels, oral glucose tolerance tests, and HbA1c measurement.

Given the link between these conditions, individuals living with T2DM should be vigilant about potential signs of sleep apnea. These can include loud snoring, choking, or gasping during sleep, and excessive daytime sleepiness.

Effective management of both sleep apnea and T2DM involves a multifaceted approach. This can include lifestyle modifications, medical interventions, and, in serious cases, surgical options.

  • Glucose management: Controlling blood sugar levels is key to managing T2DM. Typically, this involves a combination of adhering to dietary recommendations and regular exercise. In some cases, a person with T2DM may also need to take medication such as metformin.
  • Continuous Positive Airway Pressure (CPAP): CPAP therapy is the most common treatment for sleep apnea. It involves wearing a mask during sleep that delivers a continuous stream of air, preventing airway collapse.
  • Oral device: For people who find it difficult to wear a mask at night, oral devices are available to help alleviate the symptoms of sleep apnea. For example, a mandibular repositioning mouthpiece keeps the lower jaw in a position to stop it from sliding backwards and blocking the upper airway.
  • Weight Loss: Addressing obesity is a key component of managing both conditions. Weight loss can improve insulin sensitivity, alleviate symptoms of sleep apnea, and contribute to better overall health. Dietary changes and consultation with a dietitian can guide individuals in achieving sustainable weight loss.

Sleep apnea and type 2 diabetes mellitus (T2DM) have a bidirectional relationship. This means that both conditions influence the other. As such, it is important to diagnose and successfully manage both conditions.

Lifestyle modifications, including weight management, regular exercise, and glucose control, form the foundation of effective management. Medical interventions, such as CPAP therapy and medications, can also help an individual to address both conditions.