Obstructive sleep apnea (OSA) is a common and frequently unrecognized disorder. It is often found in patients with obesity, diabetes, and cardiovascular disease, and there is growing evidence that sleep apnea is independently associated with increased cardiovascular morbidity. This article reviews the presentation, diagnosis, and treatment of OSA and its related health risks. It also discusses the proposed associations between OSA and diabetes and insulin resistance.
Diabetes and obstructive sleep apnea (OSA) are common disorders that often coexist. One explanation for this overlap is the presence of shared risk factors such as obesity. There may also be a more complex relationship between these conditions in which an underlying metabolic disorder predisposes to both or in which metabolic and autonomic abnormalities associated with one influence the development of the other. Because both diabetes and OSA are associated with increased cardiovascular morbidity and mortality, it is possible that the presence of both conditions results in additive or even synergistic health risks.
For these reasons, it is important to have heightened awareness of symptoms and signs of OSA in a diabetic patient population. This review discusses the pathophysiology, clinical significance, presentation, diagnosis, and treatment of OSA. It also examines associations between OSA and features of diabetes such as insulin resistance and autonomic neuropathy.
Like OSA, diabetes is a common disorder. It is estimated that 8% of American adults have diabetes, 90% of which is classified as type 2 diabetes. Studies have shown that these patients have a significantly increased risk of atherosclerotic disease and cardiovascular mortality compared to those without diabetes. Much emphasis has been placed on the recognition and treatment of modifiable cardiovascular risk factors such as tobacco abuse, dyslipidemia, and hypertension in this population.