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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Obstructive sleep apnea as a risk factor for type 2 diabetes.

Nader Botros¹, John Concato, Vahid Mohsenin

¹Division of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Conn.

The American Journal of Medicine

|December 5, 2009

Summary

Obstructive sleep apnea (sleep apnea) increases the risk of developing type 2 diabetes, independent of other factors. Positive airway pressure therapy may reduce this risk in severe cases.

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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Area of Science:

Endocrinology
Sleep Medicine
Public Health

Background:

Obstructive sleep apnea (sleep apnea) is linked to glucose intolerance and type 2 diabetes (diabetes).
Previous studies documented co-occurrence but not independent risk.
The relationship between sleep apnea severity and incident diabetes requires further investigation.

Purpose of the Study:

To determine if sleep apnea independently predicts the subsequent development of diabetes.
To assess the association between sleep apnea severity and incident diabetes.
To examine the impact of positive airway pressure (PAP) therapy on diabetes risk.

Main Methods:

Observational cohort study of 544 patients without pre-existing diabetes undergoing polysomnography.
Patients categorized into quartiles based on apnea-hypopnea index severity.
Incident diabetes defined by fasting glucose levels and physician diagnosis; PAP compliance analyzed.

Main Results:

Increasing sleep apnea severity correlated with higher diabetes risk (P < .001).
Independent association found: sleep apnea increases incident diabetes risk (HR per quartile 1.43; CI 1.10-1.86) after adjustments.
Positive airway pressure use attenuated diabetes risk in severe sleep apnea cases (P=.04).

Conclusions:

Sleep apnea is an independent risk factor for developing type 2 diabetes.
Regular positive airway pressure use may mitigate the diabetes risk associated with severe sleep apnea.