The Sleep Apnea-Diabetes Connection

by David Mendosa Patient Advocate

People who have diabetes and those who have sleep apnea have several things in common. There's no cure for either condition, but both can be controlled.

The connection is even closer. About 40 percent of all men who have type 2 diabetes also have sleep apnea, according to research that Daniel Einhorn, the director of the Sharp Diabetes Treatment and Research Center in San Diego, and three associates presented at the 65th Scientific Sessions of the American Diabetes Association in poster 2415. They found that the proportion went up to 61 percent among men older than 65.

Another similarity is that a lot of people with both conditions don't know that they have it. The U.S. government has told us for years that one-third of all Americans with diabetes haven't been diagnosed yet.

That's a lot, but it's even higher with sleep apnea. Fully 93 percent of women and 82 percent of men with moderate to severe sleep apnea haven't been diagnosed, according to a study in the journal Sleep.

The consequences of uncontrolled diabetes and of sleep apnea can also be much more severe than most people might guess. How important can it be to have "a little sugar" in the blood and too little sleep?

Those of us who have diabetes know how important it is to keep our blood glucose levels in check. But few of us recognize the importance of sleep apnea symptoms.

The immediate result of untreated sleep apnea is constant fatigue. It can also lead to poor concentration, depression, and lack of energy. Unless treated, it reduces our insulin sensitivity, according to research by German scientists. The consequences of untreated sleep apnea can also include high blood pressure, heart attacks, strokes, and accidents while driving and at work, the National Institutes of Health say.

The heart attacks and strokes of untreated sleep apnea can be deadly in the long run. Traffic accidents can be deadly in the short run. People with moderate to severe sleep apnea have an up to fifteen-fold greater risk of motor vehicle accidents, according to research by Swiss scientists.

When you have sleep apnea, your throat muscles relax a bit too much and block the airway. That causes brief but frequent interruptions in your breathing.

It's not something that most people notice. The first hint of trouble usually comes from the person they sleep with. If your bed mate complains about your snoring, you might well have sleep apnea.

But even if you don't snore, you might have it. If your bed mate says that you stop breathing when you sleep or you repeatedly gasp and then make a coughing sound, you've got an even better clue.

I certainly had no idea that I had sleep apnea. But thank goodness that my wife thought I might have it.

She was able to drown out my snoring by listening to the radio with earbuds. But she encouraged me to see my doctor about it anyway. I did. Later I wrote about it in the November 2004 issue of "Diabetes Wellness News." That article is now also online at my website.

If you suspect that you might have sleep apnea, the first thing you might want to do is check out a couple of questionnaires. The "Berlin Questionnaire" is the better known one. The best online version I've found is here.

Another one is the "Epworth Sleepiness Scale." You can view it on the website of ResMed Corp. here.

ResMed is the leading manufacturer of the devices that treat sleep apnea. They are called positive airway pressure devices. They keep the airway open by gently delivering a stream of air through a small nasal mask or a so-called "pillows system."

The most common device is the CPAP or continuous positive airway pressure device. More sophisticated are the APAP or automatic positive airway pressure device and the bilevel device.

In a subsequent article here I will write about my experience of getting treated for sleep apnea. In the two and one-half years since my diagnosis I have learned a few more things about it. I will share some of these tips here.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.