In my most recent blog article here I highlighted several of the things that diabetes and sleep apnea have in common. There is one more similarity: when we have diabetes or sleep apnea – or both conditions – we have to become an advocate for our own treatment.

Unlike most of our health problems, we can’t turn ourselves over to a doctor to prescribe a pill or an operation and assume that will solve the problem. After seeing our doctor for tests and prescriptions, we have to take care of our diabetes and our sleep apnea ourselves each day.

Since more people with diabetes also have sleep apnea than practically any other complication that I can think of except neuropathy, we need to know exactly how to advocate for our treatment. This is especially true because, as I wrote in the previous article here, most people with diabetes haven’t yet heard a doctor tell them that they have sleep apnea.

When we get that diagnosis – or better yet – even before that diagnosis, we need to know the choices that we have in the treatment of our sleep apnea. When a doctor diagnosed my sleep apnea about three years ago, I knew some of my options. And I have learned a few things since then that I wish I knew then.


By far the most common and effective treatment for sleep apnea is the CPAP or continuous positive airway pressure device. More sophisticated are the APAP or automatic positive airway pressure device and the bilevel device.

If your condition requires a bilevel device, you can count on your doctor to prescribe it. But it’s likely that no one will even mention that you could get an APAP.

I didn’t even know it existed until a couple of months ago, when I started using the ResMed S8 Autoset Vantage APAP. It works for me far better than my old Respironics REMstar Plus CPAP.

ResMed and Respironics are the two leading sleep apnea companies. They are close in market share. ResMed is the global leader. Respironics leads in the U.S.

ResMed, however, is the only company working on publicizing the relationship between diabetes and sleep apnea. ResMed resulted from the connection between Colin Sullivan, an Australian researcher who invented the first CPAP in 1981, and Dr. Peter Farrell, who founded the company.

An APAP has many advantages over a CPAP. An APAP monitors the state of our upper airway and adjusts pressure automatically throughout the night based on the severity of our breathing problems. Then it delivers the minimum pressure that we need to treat our sleep apnea. This is especially useful for people like me who have lost weight, but people on varying medications or seasonal allergies can also benefit from an APAP.

A CPAP, like my first device for sleep apnea, delivers a fixed pressure throughout the night. A sleep technician guessed how much pressure I needed, and there was only one way I could change it, short of seeing a sleep doctor. And since leaving California two and one-half years ago, I hadn’t found one here in Colorado.

My CPAP does have a setting for three different altitudes. It had begun to seem to me that the pressure setting was too high, because I would often exhale so much air through the mask that it seemed to bubble out of it. Setting the altitude to a lower level than the mile high setting appropriate to where I live in Boulder made it better.