Treating sleep apnea could help prevent diabetes

Chuck Bednar for – @BednarChuck

Men and women with prediabetes, a disorder marked by slightly elevated blood sugar levels, could be able to keep their condition from progressing to full-blown diabetes by treating any sleep disorders they have, according to a new study.

As researchers at the University of Chicago Medical Center and McGill University in Montreal explain, there is a link between prediabetes, a condition that affects 57 million people in the US, and obstructive sleep apnea (OSA), an ailment that results in breathing difficulty during slumber.

sleep apnea“Although obstructive sleep apnea is associated with impaired glucose tolerance and diabetes, it remains unclear whether OSA treatment with continuous positive airway pressure (CPAP) has metabolic benefits,” they wrote in a paper published online last Tuesday by the American Journal of Respiratory and Critical Care Medicine.

They set out to find the answer in a controlled study in which 39 participants were randomly assigned to receive either eight hours of CPAP treatment each night or an oral placebo. The researchers then monitored their sleep using a diagnostic tool known as a polysomnogram to record the biophysiological changes that occurred during sleep.

CPAP reduces diabetes, cardiovascular disease risks

As lead author Dr. Sushmita Pamidi, a former fellow at the University of Chicago who now teaches at McGill University, and her colleagues explained, many people with prediabetes also have untreated OSA. Using CPAP, a device which constantly blows air into the lungs through a tube and facemask, helps keep the upper airway open and allows them to breath better.

Dr. Pamidi said that their study showed that people with prediabetes who use CPAP “can lower their risk of progressing to diabetes when CPAP is used for eight hours, a full night’s sleep,” and that while “eight hours of CPAP per night can be difficult to achieve” in real-life conditions, the findings “should provide a strong incentive for anyone with sleep apnea, especially prediabetic individuals, to improve adherence to their treatment for cardio-metabolic risk reduction.”

Sleep apnea is common among overweight and obese men and women, the study authors noted, and can cause a person’s upper airway to become closed off during sleep, causing a temporary reduction in oxygen levels. The condition has been associated with increased risk of high blood pressure, stroke and cardiovascular disease, as well as a decrease in the body’s ability to regulate blood sugar levels that could ultimately result in diabetes.

Twenty-six of the participants were randomly assigned to receive CPAP treatments, while the remaining 13 were given a placebo in pill form 30 minutes prior to bedtime. The researchers then monitored their glucose metabolism both before and after treatment, as well as their levels of the stress hormone noradrenaline and their blood pressure.

After two weeks, blood sugar control improved for those in the CPAP group compared to the oral placebo group, the researchers said. Furthermore, the ability of insulin to regular their blood sugar improved and they had lower blood pressure and reduced levels of norepinephrine versus the placebo group, suggesting that treating sleep apnea could reduce risk-factors for diabetes and cardiovascular disease in at-risk patients.


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