Type 2 diabetes and sleep apnea

Just like for type 2 diabetes, one of the main risk factors for sleep apnea is obesity. Consequently, people with type 2 diabetes also have a higher risk of developing this sleep disorder.

Although research on the relationship between type 2 diabetes and sleep apnea is not conclusive, it is nevertheless important that diabetic individuals who are overweight verify that they do not have sleep apnea.

In Québec, only a quarter of the estimated 325,000 sleep-apnea sufferers will be diagnosed.

Sleep apnea, also known as “obstructive sleep apnea” (OSA), occurs when a person’s breathing is repeatedly interrupted during sleep.

During sleep, the muscles around the tongue and throat relax. When the soft tissue in the back of the throat supporting the soft palate collapses, it blocks the passage of air to the lungs, and the person stops breathing. This type of apnea can last from 30 seconds to a minute, after which the person wakes up with a start to catch his breath, his heart pounding.

Most of the time, the person will be not be aware of his condition. He may, however, suffer from daytime sleepiness, impacting his performance of everyday activities and even proving dangerous (while driving, for example).Heart problems are also possible due to frequent awakenings in a state of panic.

Sleep apnea often occurs in people with a large waist circumference and a thick or short neck. Sleep apnea is more prevalent in men than women.

Sleep apnea is more frequent among people with type 2 (non-insulin dependent) diabetes but it is also under-diagnosed.

Sleep apnea also increases the risk of certain diabetes complications, such as nephropathy (kidney damage), retinopathy (damage to the eye’s retina) or nerve or blood-vessel damage.

While snoring can be an indicator of sleep apnea for some people, the best way to identify OSA is to have polysomnography at a sleep disorder lab.

The person sleeps at the lab for a full night, hooked up to equipment that monitors and records everything that occurs during sleep (full awakenings, partial awakenings, heart rate and rhythm, etc.). Some CLSCs also loan equipment for partial polysomnographies at home, which are mainly done to calibrate positive airway equipment.

Polysomnography is normally prescribed by a pneumologist (lung specialist) who specializes in sleep apnea. To date, there is no written test to detect this problem.

There are several recommended treatments and devices for sleep apnea, as well as some surgical procedures that have met with only qualified success.

To date, continuous positive airway pressure (CPAP) has proven to be the treatment best suited to the needs of the majority of sleep-apnea sufferers. A mask worn over the face, nose and/or mouth is hooked up to a machine that delivers a continuous flow of air into the trachea to keep the soft palate from collapsing, allowing the person to breathe without interruption during sleep. Ordinary air, rather than oxygen, is normally used.

The CPAP machine is portable. It sits on a night table next to the bed and can be taken along when travelling. It often comes equipped with a humidifier to moisten the air being forced into airways. Some CPAP machines have a smart card that records the events (complete awakenings, partial awakenings) that occur during sleep.

The cost of a CPAP machine can vary from $1,200 to $2,200, as is covered up to 80% by most private medical insurers.

Other aids might be proposed, such as positional therapy to stop you from sleeping on your back (such as sweaters with reinforced backs), or nasal strips to keep the upper airway open. Exercises that strengthen the muscles of the neck and throat can be very helpful, such as singing.

In Québec, the non-profit organization, Fondation Sommeil, supports people suffering from such sleep disorders as apnea, narcolepsy-cataplexy (sudden attacks of sleep and temporary paralysis during the day), bruxism (teeth grinding or jaw clenching during sleep), restless leg syndrome (RLS) (unpleasant sensations in the legs that makes it difficult to fall asleep), sleep walking, insomnia, etc.

Fondation Sommeil has a bilingual help line to provide information and referrals. It also runs awareness programs and organizes conferences.

For more information:

Fondation Sommeil (Mainly French, with English documentation)
(514) 522-3901