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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnea, daytime sleepiness, and type 2 diabetes
1School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA 15261, USA. chasense@pitt.edu
The Diabetes Educator
|June 16, 2007
Summary
Obstructive sleep apnea (OSA) and type 2 diabetes frequently coexist, with a bidirectional relationship where each condition worsens the other. Further research is needed to clarify causality and treatment implications.
Area of Science:
- Endocrinology
- Sleep Medicine
- Metabolic Disorders
Background:
- Obstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) are prevalent chronic conditions.
- Shared risk factors include advanced age and central obesity.
- Evidence suggests a frequent coexistence and bidirectional association between OSA and T2DM.
Purpose of the Study:
- To review the existing literature on the relationship between obstructive sleep apnea, daytime sleepiness, and type 2 diabetes mellitus.
- To assess the current state of evidence regarding these interconnected conditions.
Main Methods:
- A comprehensive literature search was conducted on Medline and CINAHL.
- Keywords included "sleep apnea syndromes," "obstructive sleep apnea," "disorders of excessive somnolence," "type 2 diabetes mellitus," and "insulin resistance."
- The review focused on published English-language research studies in adults (19+ years), identifying 36 relevant research studies, with no randomized clinical trials and one qualitative study.
Main Results:
- Obstructive sleep apnea and type 2 diabetes share risk factors like age and central obesity.
- A bidirectional association exists, where each condition exacerbates the other.
- Mechanisms include hypoxia, sleep fragmentation, sympathetic nervous system activation, increased inflammatory cytokines, altered leptin levels, and impaired mood due to daytime sleepiness, all affecting glucose metabolism and diabetes management.
Conclusions:
- Type 2 diabetes is prevalent in individuals with obstructive sleep apnea, though causality is not definitively established.
- Further research, particularly randomized clinical trials, is essential to elucidate the impact of obstructive sleep apnea and daytime sleepiness on type 2 diabetes.
- Understanding these relationships is crucial for effective patient management.
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