Sleep apnea and type 2 diabetes

• Published in: Journal of diabetes investigation 2018-09, Vol.9 (5), p.991-997
• Main Authors: Muraki, Isao, Wada, Hiroo, Tanigawa, Takeshi
• Format: Article
• Language: English
• Subjects: Apnea; Cardiovascular diseases; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; Daytime; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - therapy; Glucose metabolism; Glucose tolerance; Humans; Insulin; Insulin resistance; Insulin Resistance - physiology; Patients; Respiratory tract; Review; Risk Factors; Sleep; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - therapy; Sleep deprivation; Sleep disorders
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.12823

The aim of the present review was to clarify the association between obstructive sleep apnea (OSA) and type 2 diabetes, and discuss the therapeutic role of continuous positive airway pressure (CPAP) in type 2 diabetes. OSA patients are more likely than non‐OSA populations to develop type 2 diabetes, while more than half of type 2 diabetes patients suffer from OSA. Similar to Western countries, in the East Asian population, the association between these two disorders has also been reported. CPAP is the primary treatment for OSA, but the effect of CPAP on comorbid diabetes has not been established. CPAP improved glucose metabolism determined by the oral glucose tolerance test in OSA patients, and several studies have shown that CPAP improves insulin resistance, particularly in obese populations undergoing long‐term CPAP. Diabetes is associated with other sleep‐related manifestations as well, such as snoring and excessive daytime sleepiness. Snoring is associated with the development of diabetes, and excessive daytime sleepiness appears to modify insulin resistance. Well‐designed studies are required to clarify the therapeutic effect of CPAP on diabetes. As both diabetes and OSA lead to cardiovascular disease, clinicians and healthcare professionals should be aware of the association between diabetes and OSA, and should take CPAP and health‐related behaviors into consideration when treating patients with diabetes and/or OSA. Obstructive sleep apnea (OSA) leads to sympathetic neural activation, systemic inflammation, oxidative stress loading, and changes in hormonal systems, whereas diabetes affects sleep conditions via the central respiratory system. OSA treatment, such as continuous positive airway pressure, resolves some of these factors, and may exert a therapeutic effect on diabetes.