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Diabetes, Cardio-Metabolic Newsletter
Sleep Apnea- DM
Sleep apnea can worsen blood sugar control in people with Type 2 diabetes by disrupting the deepest stage of sleep, a new study
suggests. The findings provide another good reason for people with sleep apnea to wear a CPAP mask that helps assure uninterrupted
breathing, the standard treatment for the condition, throughout the night.
2/24/2014
It is well known that sleep apnea, which causes breathing pauses and dangerous drops in oxygen during sleep, sharply raises
the risk of Type 2 diabetes. More severe cases of sleep apnea are generally associated with poorer blood sugar control in
diabetics.
While breathing pauses can occur throughout the night in apnea patients, the new study, published in Diabetes Care, found
that episodes that occurred during the rapid eye movement, or REM, phase of sleep had the most detrimental effects on longterm blood sugar control.
Most REM sleep occurs in the early morning hours before waking. But research shows that many patients remove their
CPAP, or continuous positive airway pressure, mask in the middle of the night because it can feel uncomfortable, said Dr.
Babak Mokhlesi, an author of the new study and the director of the sleep disorders center at the University of Chicago.
As a result, their apnea is more likely to go untreated during REM sleep, a time that may be particularly important for anyone
with diabetes, Dr. Moklhesi said.
MY COMMENTARY
1. not all need CPAP, which many folk can’t tolerate: have then be evaluated by sleep folk, oral
surgeon , like Silverstein at Paoli, who developed dental devices : these are easier to use for whole
night than CPAP,
IN THE RIGHT PATIENT
2. Dx with 4 questions- ask all patients with DM, as many folk won’t complain
Awaken in AM as tired as went to sleep; snoring; so tired driving feels like they want to sleep
while driving; nod off to sleep at the drop of a hat even when wants to stayawake (watching ball
game, Downton Abbey  )
3. Even if not bothered by symptoms- refusing sleep study, treat!!
As chronic, untreated OSA can lead to pulmonary hypertension, CHF, O2 requirement
Depression