Why Does Apnea Cause Diabetes?

[player]

Curious.








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[PaulaO2]

Sleep apnea alters our sleep cycle and stages of sleep. Some studies have linked altered sleep stages with a decrease in growth hormone, which plays a key role in body composition such as body fat, muscle, and abdominal fat. Researchers have found a possible link between sleep apnea and the development of diabetes and insulin resistance (the inability of the body to use insulin).

Abstract

Type 2 diabetes is a major public health concern with high morbidity, mortality, and health-care costs. Recent reports have indicated that the majority of patients with type 2 diabetes also have obstructive sleep apnea (OSA). There is compelling evidence that OSA is a significant risk factor for cardiovascular disease and mortality. Rapidly accumulating data from both epidemiologic and clinical studies suggest that OSA is also independently associated with alterations in glucose metabolism and places patients at an increased risk of the development of type 2 diabetes. Experimental studies in humans and animals have demonstrated that intermittent hypoxia and reduced sleep duration due to sleep fragmentation, as occur in OSA, exert adverse effects on glucose metabolism. Based on the current evidence, clinicians need to address the risk of OSA in patients with type 2 diabetes and, conversely, evaluate the presence of type 2 diabetes in patients with OSA. Clearly, there is a need for further research, using well-designed studies and long-term follow-up, to fully demonstrate a causal role for OSA in the development and severity of type 2 diabetes. In particular, future studies must carefully consider the confounding effects of central obesity in examining the link between OSA and alterations in glucose metabolism. The interactions among the rising epidemics of obesity, OSA, and type 2 diabetes are likely to be complex and involve multiple pathways. A better understanding of the relationship between OSA and type 2 diabetes may have important public health implications.

[zonk]

Curious.

From ResMed: Comorbidities of sleep-disordered breathing (SDB)
http://www.resmed.com/au/en/healthcare-p...ities.html

Scroll down for: SDB and type 2 diabetes

[worn_out_in_lebanon]

As far as why, I would take a guess that bad sleep contributes to over-eating, and over-eating contributes to insulin resistance.
(over-eating in terms of total calories and dense calorie food, not necessarily volume of food)

A webmd article notes that bad sleep can contribute to over-eating in four ways:
- eating to compensate for low energy
- affects frontal lobe which is involved in impulse control
- affects the two hunger hormones ghelrin and leptin, increasing the one to make you eat, and decreasing the one to make you stop
- decreases insulin sensitivity 30%

http://www.webmd.com/diet/sleep-and-weight-loss

[DariaVader]

sleep apnea causes the release of cortisols in response to the arousals. Excess cortisol causes insulin resistance. Insulin resistance causes excess insulin and excess hunger. Excess insulin causes fat to be distributed to the belly which increases insulin resistance. Excess fat caused by excess insulin and excess hunger lead to increased weight which increases apnea

[parkerdt]

Worse, according to my MD - they are bi-directional diseases and feed each other.

[Mosquitobait]

Very interesting replies. My sleep doctor simply told me that the ups and downs I've been experiencing with blood sugar since about December are likely due to increased sleep disorder. He thinks my numbers will stabilize again a few weeks after starting the cpap. Metformin and I don't get on well at higher dosages, so I hope this is so.

[quiescence at last]

In an effort to control my newly diagnosed diabetes (and ironically - newly diagnosed apnea) I adjusted my diet, killed the caffeine, and faithfully administered CPAP. My first A1C test after these moves showed a marked decrease in blood sugar, and with the resulting numbers I would not have been diagnosed as diabetic. I am nearing the end of my 2nd quarter on CPAP, and will be getting my 2nd A1C soon, and hoping for confirmation that IR is decreasing.

What I was told by sleep nurse was that apnea causes things that 'mimic' diabetes, as DVader has described. Anyone not aware that I was an apnea sufferer would see the symptoms as a clear indication of diabetes.

So, Mosquitobait, I would guess and hope that Metformin dosage will eventually not need to be so high, and that it may become unnecessary.

QAL