The Sleep Disorders Center

Here is a wake-up call to the millions of American men and women with type 2 diabetes: Snoring at night or nodding off during the day may be symptoms of obstructive sleep apnea.

Persons with type 2 diabetes who drag themselves through the day may be among the 36 percent of diabetics suffering from obstructive sleep apnea, according to a study in the medical journal Endocrine Practice.

Sleep apnea is a potentially life-threatening problem affecting one out of three people with diabetes.

Depriving your body of oxygen can cause high blood pressure, heart attacks, stroke and now, researchers at Ohio State University have linked sleep apnea to type II diabetes. Sleep apnea worsens glucose control and worsens the body's responsiveness to insulin. A separate study at UCLA showed that adults who suffer from sleep apnea are three-times more likely to have diabetes. Researchers say they will conduct further studies to provide more insight into the link between these two common problems.

Based on evidence linking the two disorders, health experts are encouraging physicians to assess their diabetes patients for sleep apnea symptoms and to screen sleep apnea sufferers for metabolic disease. The recommendation comes from the International Diabetes Federation (IDF) Task Force on Epidemiology and Prevention.

Treatment is Available for Sleep Disorders

Obstructive sleep apnea (OSA) is related to a multitude of health risks, including heart disease, high blood pressure, depression and sexual dysfunction. People with obstructive sleep apnea also have a markedly increased risk of severe motor vehicle crashes involving personal injury, according to a new study.

The study of 800 people with sleep apnea and 800 without the nighttime breathing disorder found that patients with sleep apnea were twice as likely as people without sleep apnea to have a car crash, and three to five times as likely to have a serious crash involving personal injury. Overall, the sleep apnea group had a total of 250 crashes over three years, compared with 123 crashes in the group without sleep apnea.

Approximately 2.4 to 3.9 million licensed commercial drivers in the United States are estimated to have OSA. In addition to being unrecognized or unreported by drivers, OSA often remains undiagnosed by many primary care clinicians.

Philip Parks, MD, MPH, Medical Director of Lifespan's Employee Health and Occupational Services, is the study's lead author. He worked with researchers at the Cambridge Health Alliance on the study published in the March 2009 edition of the Journal of Occupational and Environmental Medicine. Parks says, "It is well-known that obesity, a leading risk factor for obstructive sleep apnea, is on the rise in the United States. Truck drivers with sleep apnea have up to a 7-fold increased risk of being involved in a motor vehicle crash."

Over the 15-month study period, 456 commercial drivers were examined from over 50 different employers. Seventy-eight (17%) met the screening criteria for suspect OSA. These drivers were older and more obese, and had a higher average blood pressure.

Getting a quality night's sleep is one of the things that we all need to be focused on to stay healthy into the future. Major risk factors for sleep apnea include being overweight, male and being over age 40, although it can can affect both males and females at any age. Talk to your doctor about treatments for sleep apnea that may include lifestyle changes, thuse use of oral appliances and surgery. Nasal continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea.

For More Information

To learn more about sleep disorders, talk with your physician and call the Sleep Disorders Center at St. Mary's Regional Medical Center: (580) 249-5870.

You may also want to visit these Web sites:

What is Sleep Apnea?

Sleep apnea is characterized by a number of involuntary breathing pauses or "apneic events" during a single night's sleep—sometimes as many as 20 to 30 or more events per hour. These events are almost always accompanied by snoring between apnea episodes, although not everyone who snores has sleep apnea. Sleep apnea may also be noted by choking sensations. The frequent interruptions of deep, restorative sleep often lead to early morning headaches and excessive daytime sleepiness.

Apnea occurs when the throat muscles and tongue relax during sleep and partially block the opening of the airway. During the apneic event, the person is unable to breathe in oxygen and to exhale carbon dioxide, resulting in low levels of oxygen and increased levels of carbon dioxide in the blood. The reduction in oxygen and increase in carbon dioxide alert the brain to resume breathing and cause an arousal. With each arousal, a signal is sent from the brain to the upper airway muscles to open the airway. Breathing is resumed, often with a loud snort or gasp. Frequent arousals prevent a person from getting enough restorative, deep sleep.

The Importance of Diagnosis and Treatment of Sleep Apnea

Diagnosis of sleep apnea is not simple because there can be many different causes. Primary care physicians, pulmonologists, neurologists, or other physicians with specialty training in sleep disorders, may be involved in making a definitive diagnosis and initiating treatment.

Tests available to help a physician diagnose a person for sleep apnea, include:

Polysomnography—a test that records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels.
Multiple Sleep Latency Test (MSLT)—a test that measures the speed of falling asleep. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep.

Individuals who fall asleep in less than five minutes are likely to require some type of treatment for sleep disorders. Diagnostic testing is performed in a sleep lab or center.

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