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Contemporary Reviews in Sleep Medicine |

Obstructive Sleep Apnea and Diabetes: A State-of-the-Art Review

Sirimon Reutrakul, MD; Babak Mokhlesi, MD, M.Sc.
Author and Funding Information

Conflict of interest: BM is supported by National Institutes of Health grant R01HL119161 and has served on the advisory board of Itamar Medical.

SR receives research grant from Merck Sharp and Dohme, and honoraria from Sanofi Aventis, Medtronic and Novo Nordisk.

aDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

bDivision of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL, U.S.A

cSection of Pulmonary and Critical Care, Sleep Disorders Center, Department of Medicine, The University of Chicago, Chicago, Illinois, U.S.A

Address for Correspondence: Babak Mokhlesi, MD, M.Sc., Section of Pulmonary and Critical Care, Sleep Disorders Center, The University of Chicago, 5841 S. Maryland Ave, MC6076/Room M630, Chicago, IL 60637-1470.


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.05.009
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Abstract

Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing. Despite the strong association between OSA and type 2 diabetes, the effect of treatment with continuous positive airway pressure (CPAP) on markers of glucose metabolism has been conflicting. Variability with CPAP adherence may be one of the key factors behind these conflicting results. Lastly, accumulated data suggests an association between OSA and type 1 diabetes as well as gestational diabetes. This review will explore the role of OSA in the pathogenesis of type 2 diabetes, glucose metabolism dysregulation and complications of type 2 diabetes. The association between OSA and diabetic complications as well as gestational diabetes will also be reviewed in the online supplement.


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