If you’re suffering from diabetes, it’s important to keep in mind you’re not the only one.
Nearly 35 million Americans — or more than 1 out of every 10 people — have diabetes, according to the latest data from the Centers for Disease Control and Prevention.
Many others are at risk of developing diabetes at some point in their lives; 88 million Americans have prediabetes, or blood glucose levels that are too high, but not at the point of diabetes, according to the CDC. Prediabetes is often a precursor to type 2 diabetes.
This is a remarkably common disease — and if you’re suffering from it, you can still live a long and full life. It should be pointed out, though, that there is a close link between sleep apnea and diabetes. Sleep apnea, if left untreated, can make your fight against diabetes tougher. It can also lead to additional health problems, including heart disease.
Doctors, including sleep doctors, will tell you that getting a sleep apnea test when you have diabetes or prediabetes is one of the smartest things you can do. Not only because sleep apnea contributes to diabetes and can worsen it, but because blood sugar is very difficult to control even with insulin if you have undiagnosed or untreated sleep apnea.
That’s why it’s important to understand the connection between sleep apnea and diabetes. By treating your sleep apnea, you give yourself a better foundation for keeping your diabetes in check.
How Obesity, Sleep Apnea, and Diabetes are Linked
Sleep apnea and diabetes often go hand in hand, with studies showing 70% of people with type 2 diabetes also suffer from sleep apnea.
Researchers continue to look at how sleep apnea increases your odds of getting diabetes, but one common thread is clear: obesity. If you’re overweight, you’re more likely to develop both sleep apnea and type 2 diabetes, the most common form of the disease.
Here’s how obesity can lead to diabetes: Insulin is a hormone that helps sugar, or glucose, navigate from the blood into your cells. This is an important process because it allows sugar to be stored in your cells for energy. But when you’re overweight, your cells do not react to insulin’s effects. When your cells become insulin resistant, sugar is unable to enter your cells and your blood sugar increases. After a while, type 2 diabetes develops.
At the same time, obesity contributes to sleep apnea. Remember, obstructive sleep apnea — the most common form of sleep apnea — occurs when the airway is partially or fully blocked during sleep. This cuts off airflow and is usually accompanied with snoring and loud snorts. Being overweight can compound sleep apnea by adding pressure on your upper airway; the fat deposits along the upper airway suppresses airflow and makes breathing while you sleep more difficult. By watching your weight, you remove a variable that contributes to sleep apnea — as well as give yourself a much better chance of avoiding type 2 diabetes.
Undiagnosed Sleep Apnea Makes Diabetes Worse
Left untreated, sleep apnea can make managing your diabetes even harder.
That’s because sleep fragmentation — or the restless and often uncomfortable sleep you experience with sleep apnea — has been shown to decrease insulin sensitivity and glucose tolerance. Insulin resistance causes blood sugar levels to spike and increases blood pressure. (We’ll touch on the health consequences that can stem from this in a moment.) Researchers have also found sleep apnea is connected to increased levels of cortisol, a hormone that gets in the way of cells using insulin.
Hypoxemia, or the periodic breathing interruptions tied to sleep apnea, also set off a reaction inside the body that impairs glucose tolerance. In short: managing glucose levels is hindered by undiagnosed sleep apnea.
Sleep Apnea and Diabetes Leads to Heart Disease
Heart disease is one of the common health problems tied to sleep apnea and diabetes.
As we just mentioned, sleep apnea can lead to higher blood sugar levels, which increases blood pressure. Also known as hypertension, high blood pressure isn’t good for your cardiovascular system. Hypertension leads to friction against the artery walls, which ultimately leads to more plaque building up to cover the ruptures in your artery lining.
Over time, the plaque deposits decrease blood flow to the heart and can lead to major health issues, like heart attack and heart failure.
You can read more in our recent article on how sleep apnea increases your risk of heart disease.
Diabetes also greatly increases your risk of heart disease: diabetics are twice as likely to suffer from heart disease — as well as other medical issues, like stroke — than people who do not have diabetes, according to the CDC. For diabetics, high blood glucose damages blood vessels, which in the long run wears down the heart. Another concern is that diabetics tend to develop heart disease at a younger age.
Why Treating Sleep Apnea Is Important for Diabetes
By this point, you’re probably noticing a vicious cycle: Diabetes is linked to excess weight; obesity makes sleep apnea worse; sleep apnea, if untreated, contributes to insulin resistance and makes it harder to control glucose levels; sleep apnea can also increase your risk of suffering from health issues like heart disease — something that you’re already at a higher risk of developing if you have diabetes.
It’s a complex balance that can be frustrating to deal with. But by tackling sleep apnea head on, it can make it easier to handle your diabetes and avoid further health problems.
CPAP Can Help Diabetes
Researchers from the University of Chicago found continuous positive airway pressure (CPAP) treatment, which consists of using a CPAP machine to help open the airway and improve breathing, had a remarkable impact.
After one week of CPAP treatment, the study’s participants showed lower 24-hour glucose levels, as well as improved glucose response after breakfast for type 2 diabetics. The researchers also found the early-morning spike in blood pressure in people who have type 2 diabetes was reduced by 45% due to CPAP treatment. In other words: Treating sleep apnea helps type 2 diabetics better regulate glucose levels.
CPAP Can Help Prediabetes
Later research from the University of Chicago also indicated CPAP treatment for people with prediabetes lowered their risk of developing diabetes. After two weeks of nightly CPAP treatment, participants showed improved blood sugar regulation and improvements in their insulin resistance, compared to those who did not receive CPAP therapy.
If you, or someone you know are diabetic or prediabetic and suffer from sleep apnea symptoms, you should set up a sleep test sooner rather than later. For other indications you should get tested, read our recent article 7 serious signs you might have sleep apnea as a guide. Ultimately, if you’re undiagnosed but suspect you have sleep apnea, reach out today for an evaluation.
By being proactive about your sleep apnea, you have a better chance of keeping your diabetes in check.
References
Tahrani, A.A., Ali A. (2014). Obstructive sleep apnoea and type 2 diabetes. European Journal of Endocrinology 10 (1): 43-50. Retrieved on March 5, 2020 from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983096/
Stamatakis, K.A., Punjabi, N.M. (2010). Effects of sleep fragmentation on glucose metabolism in normal subjects. Chest 137(1):95-101. Retrieved on March 5, 2020 from:
https://www.ncbi.nlm.nih.gov/pubmed/19542260/
Oltmanns, K.M., et al. (2004). Hypoxia causes glucose intolerance in humans. American Journal of Respiratory and Critical Care Medicine 169(11): 1231-1237. Retrieved on March 5, 2020 from:
https://www.ncbi.nlm.nih.gov/pubmed/15044204/
Pamidi, S., et al. (2015). Eight hours of nightly continuous positive airway pressure treatment of obstructive sleep apnea improves glucose metabolism in patients with prediabetes. A randomized control trial. American Journal of Respiratory and Critical Care Medicine 192(1). Retrieved on March 5, 2020 from:
https://www.atsjournals.org/doi/10.1164/rccm.201408-1564OC
Tasali, E., et al. (2013). Effective CPAP treatment of obstructive sleep apnea improves glycemic control in type 2 diabetic. Sleep. Retrieved on March 5, 2020 from:
CPAP improves glycemic control in type 2 diabetics with sleep apnea