When Two Worlds Collide: Sleep Apnea and Diabetes - CPAP.com


#1

http://www.cpap.com/blog/sleep-apnea-and-diabetes/


#2

I wish treating my Type 1 was as easy as treating my sleep apnea!

There really is no link between OSA and Type 1. They could have saved a lot of ink by saying, “Sleep Apnea and Type 2 Diabetes,” except most people don’t know what Type 2 or Type 1 mean.

The biggest obstacle (or obstruction) to CPAP treatment is getting used to the mask, but I was very fortunate. I figured out that I only breathe through my nose when I sleep. So, I just have a CPAP mask that goes over my nose.

My diagnosis came from borrowing my sister’s van. I borrowed it a few times, then told her I couldn’t drive anymore because I couldn’t stay awake! My sleep apnea specialist looked at my blood oxygenation level and told me that if I were untreated when I came into her office, she would have put me on oxygen. 90% was her cut-off level. Anything LOWER than that and the tank would come out. I was at 72%.

I encourage those of you with this problem to keep pushing for a mask that works for you. It is dangerous to be working and/or driving with untreated sleep apnea!


#3

I did some research right after I was diagnosed and, while I’m no doctor, I did read that there is some sort of link between Type 1 diabetes and sleep apnea, with studies such as this one and similar popping up in my searches.

I have mild sleep apnea and have been told that it does not require treatment. I am concerned because I’ve read about the negative effects of sleep apnea on the cardiovascular system, and also because I feel tired a lot, and because I would have no problem treating it so would like to do so if it would help. But in talking to my GP, endo, and the people who did the (at home) sleep test, all of them say that I do have sleep apnea but it’s below a level at which treatment would be recommended. I got a copy of the first sleep study I had done, and it does seem to be mild (in fact it wouldn’t have been considered sleep apnea with the criteria they used in the study I linked to above), but my oxygen level did get as low as 84% at one point. I feel like my mild sleep apnea may be related a lot to my allergies, because my nasal passages and throat are often swollen/inflamed as a result, and it seems to have corresponded with my symptoms. It is something I will ask to be monitored at regular intervals to ensure that I’ll know if it gets worse.


#4

I misspoke. There is no proof that sleep apnea CAUSES Type 1. My sleep apnea has been around for probably more than twenty years (I just wasn’t aware of it). It is due to a congenital defect in the size and shape of the back of my mouth.

84% is not mild when it comes to level of impairment.


#5

From the things I have researched I think sleep apnea would benefit T1s and T2s because it effects the overall health. Any stresser on the body can make any condition worse. Sleep is when we repair ourselves. A certain level of sleep has to be reached in order for the body to repair. If the body does not reach this level of repair on a regular bases it places a strain on how the body works. I have OSI. Since being diagnosed a few weeks ago and place on CPAP therapy I have felt a lot better. My blood pressure is more level and my BG #s have remained more stable. I no longer fall asleep at the traffic light and I find it easier to have a conversation or remember things. All and all I am getting more done in a day. It was because of that that I wanted to post this study. I was not a believer when I began therapy but now I think there is something to it. I did a hospital based sleep study. The first one I felt was terrible and I was hella cranky when they came to wake me up. The second study with the cpap I jumped out of bed before they came in to wake me. It was unbelievable. I ran home and did a few chores and ran a bunch of errands and I was chipper. It was like night and day. I was sold on getting one so I could feel like that every day. I did have trouble finding a mask. The first mask I tried during the sleep study was a nasal mask that just covered your nose. I felt like I was suffocating because I am a mouth breather. I asked to switch the mask to a full mask and once getting it they said I was out like a light. I went home with the full face but I was still having a seal issues. I have since switched back to the nasal with a chin strap and now my seal is 100%. I use a Resmed airsense 10 and it gives a report every morning which includes a little game of sorts where your trying to get as many points you can get. Each category gives you a certain amount of points and your goal is to get 100%. If your on CPAP therapy or have OSI I would encourage you to keep working on your mask until it is right for you and use it until you get use to it. The beginning is the hardest because you have to become accustomed to wearing the mask to sleep and it can become frustrating. However it is worth it if you stick to it.


#6

I also have allergies and it sucks! I was told that I also had long periods where i stopped breathing as well as long oxygenation which was scary. I started talking in my sleep recently to the point I couldn’t tell if I was sleeping or awake. Now my poor bf had quite the show at night and would be tired too come morning. He said I would really get into my dreams physically as well as talking. Let’s see…One night I nearly bit him in the shoulder cause I was fighting with an attacker but due to his quick reflexes I missed. Another I nearly decked him in the eye lol. We need to get insurance on him just for sleeping with me. Most of the activity I only knew because he told me. When I woke up in the morning I was soooo tired. I was making mistakes at work and very irritable. If I sat too long somewhere I was eventually asleep and that included my desk. I truly believe between sleep apnea and diabetes I had a stroke. My numbers were all over the place and hard to control. My body was taking a beating and then I was trying to keep up with my work load. That was just a recipe for bad things to happen. Keep a close eye on apnea. I was told that people with apnea have it from when they are in their 20. Our bodies compensates for the apnea because we are young but most people with OSI begin to really show symptoms after 45 because by then the body is somewhat fatigued and not quite able to bounce back as much as it use to.


#7

You probably have had OSI for 20 years and didn’t know it. Sleep apnea doesn’t cause diabetes. Like many things it can exasperate it. Many things wrong with us a connected. One system issue pushes another and cause a string that feed off of each other. If I had sleep apnea for 20 years that means my body has been taking a beating for 20 years and exacerbated many other things going on in my body. The only way to help prevent further issue is to understand them and focus on what our body is telling us one by one.


#8

I’m very curious about something and maybe those of you with sleep apnea can provide some answers. If a person has sleep apnea, would a lower oxygen level show up later in the day?

I’ve been suspicious for years that I may have sleep apnea due to sometimes waking myself up with a big snort, once four times during one night, but usually only perhaps a few times during a whole month. But those are the times I’m aware of what woke me; it is possible that I could be having more episodes of which I"m unaware. But whenever they check my oxygen level at the doctor’s office, it always seems to be 96% or 98% or something that sounds pretty high to me, though I really don’t know much about what is expected for a 75 year old.


#9

This is not true. Different people develop sleep apnea at different times in their lives.


#10

When you begin to breath normally then your saturation will rise. You waking up choking is the response for lack of air. It interrupts your sleep over and over not allowing you to have a deep sleep. I think I had like 11 episodes each hour and long periods of not breathing before I woke myself up. Then I only slept under 5 hours to boot. It sounds like you may have OSI. My dr didn’t speak to me he went straight for my bf. That is when I heard a totally different story than what I thought. If you live alone it’s harder to know what is going on. I was going to set up my laptop to record my sleeping so I could see what everyone else is seeing. Maybe you should consider the same. You may be able to use it to show your Dr.


#11

That is true. There is no specific time. You can have apnea at any age. However many people begin to show the beginnings of OSI earlier than when they begin therapy. Earlier on our bodies make due and carry you thru but as we age it catches up.


#12

If they won’t give you a CPAP with a blood oxygen level dropping down to 84% at night, find another doctor because that is something that can be treated, it’s not “mild”. You can even rent one for a while to figure out if it helps you feel better.

What surprised me is that you don’t have to be overweight, snore or noticeably stop breathing to have sleep apnea!

I did an overnight sleep study because I thought I had a different sleep disorder, but turns out that I was stopping breathing every 30-60s. My husband has sleep apnea and even then, I never suspect that I may have it because people usually only talk about what it looks like in men.

Here were my symptoms:

  • dry mouth at night
  • sore throat upon waking up
  • headache that comes on during the night
  • regularly getting up to pee during the night

#13

The problem is they are not only looking at that number, they are looking at the overall picture. My average oxygen throughout the night was 93%, I think. And my AHI number was only 6.5 or so. They told me they do not recommend CPAP until it’s around 10 or above. I blame in large part the company who did the sleep study, which is the only company my GP uses according to him. My GP was ready to prescribe a CPAP until he saw in the report that they did not recommend one. Then he did a 180 and refused and started to get a bit defensive/annoyed when I continued to bring it up. When I brought it up with other doctors (endo, ENT specialist) they agreed with no treatment. From studies I’ve been able to find online, they concur that there is no benefit to treating mild sleep apnea. So I don’t have any foothold such as studies I can bring in to show my doctor.

I’m planning on seeing an “integrative medicine” specialist who is an MD but with an eye to preventing future problems as well as treating current ones at some point (it’s just expensive as “prevention” anything is not covered by the government or insurance), and I think they would likely understand my concerns better. I’m not so much worried that I’m going to have any issues immediately (although I do wonder if I would feel better in any way), but I’m in my 30s. I would hate to put so much attention into keeping good control of my diabetes only to have a heart attack when I’m 55 because I’ve had (albeit mild) sleep apnea all those years. To my knowledge, they have not look at long-term outcomes of “younger” people with sleep apnea. Only shorter-term outcomes (like five years) of middle-aged or older people with sleep apnea.


#14

It’s called inappropriate sleepiness. If you fall asleep any time you sit regardless of what time it is (and you spend 6-8 hours a night doing what you believe to be “sleeping”), you might have a problem. Excessive yawning is also a sign as well.


#15

Indeed it is inappropriate sleeping lol. If it were busy at work I was cranky yet running 90 mph but if it was slow I feared sleeping. All it took was for me to sit for a time and I would fall asleep. Driving home from work I would fall asleep driving. I was afraid to drive anywhere because at some point I was fighting to keep my eyes open. According to my bf I would stop breathing in the middle of the night to the point he would sit up terrified that I stopped breathing and then all the sudden I would take a big deep breath. I began to snore so loud it became a family joke. At times I even woke myself up lol. I think sleep apnea is one of those things that gets worst with time. That is the way it seemed for me so you need to keep an eye on it and usually only when you have a partner sleeping with you do you even know how bad you are.


#16

I have been diagnosed with sleep apnea for years. Generally obstructive sleep apnea is diagnosed with the following criteria based on "Apnea-Hypopnea Index (AHI)

0-5 is normal
5-15 is mild
15 - 30 is moderate
and > 30 is severe

An auxiliary measure is the oxygen desaturation. This is how low your oxygen levels fall (at a specific time, not average). Generally:

96-97% saturation is normal
90-96% saturation is mild
80-89% saturation is moderate
and below 80% is severe

Either indicator being at a moderate level or worse is likely a consideration for treatment. Even if you have a normal AHI level, if your oxygen level is dropping overnight you could have a problem.

When I was diagnosed I had an AHI > 30, I stopped breathing at one point for three minutes and my oxygen saturation dropped into the 80s at times overnight. I had a recent study done and was found to still have my oxygen saturation dipping below 90% and had my pressures increased.


#17

@Brian_BSC, this information is very helpful. Do you happen to know of any guidelines or other formal documentation that I could show a doctor? (And this information also makes me think I really do need to look for a new GP…)


#18

There is “screening” for sleep apnea and there is diagnosis. For diagnosis, here is what WebMD says. The American Academy of Sleep Science has a more specific diagnosis guideline.

The most common tool for screen for sleep apnea is called the EPWORTH sleepiness scale. If you want to convince your GP that you may have sleep apnea and that you should be referred for a sleep study, you should do the EPWORTH evaluation.


#19

I already had this scale done as part of the at-home sleep study, so my doctor has seen it. I think my score was 12 or 13, which indicates one should follow up with their doctor. I’ve had the scale done plus two at-home sleep studies (that both indicated mild sleep apnea according to the AHI number, and the one I got a copy of also had my oxygen going down to 84%). I’m actually baffled at why he is so resistant to even trying any treatment, other than the fact that the report says it’s not needed. It’s very frustrating. For most other things he is good at giving me appropriate referrals when needed.


#20

Usually the person going over the data is a pulmonologist/sleep doctor. If your GP is the one doing everything that may be the problem. I mentioned to my GP I was having trouble and she referred me to a pulmonologist and he ordered the sleep study.