In the greatest study to date on the relationship between sleep apnea and diabetes, made with more than 8,500 Canadian patients, it has been shown that there is a relationship between the obstructive sleep apnea (OSA) and the development of diabetes, whatconfirming the earliest evidence of this relationship that had been obtained in minor studies and with shorter monitoring periods.
"Our study, with a larger sample size and an average follow -up of 67 months was able to address some of the limitations of previous studies on the relationship between the obstructive apnea of sleep and diabetes," said the main author TetyanaKendzerska, from the University of Toronto."We found that among patients with obstructive sleep apnea, the initial severity of the disease predicted the consequent risk for the development of diabetes."
The findings were published online before the publication printed in the journal of the American Thoracan Society American Journal of Respiratory and Critical Care Medicine.
Sleep apnea and slight renal failure increase the risk of diabetes
The study included 8,678 adults suspected of sleep apnea without diabetes at the beginning of the study that underwent a diagnostic dream study between 1994 and 2010 and were followed until May 2011. From provincial administrative data of provincial health, it was examinedThe incidence of diabetes.
The severity of the sleep apnea was evaluated with the Apnea-hypopnea index (IAH), indicating gravity based on the number of apneas (complete cessation of air flow) and hypopneas (partial cessation of air flow)sleep time.Patients were classified as not having an Osa (IAH & LT; 5), or have slight (IAH 5-14.9), moderate (there 15-30) or severe (IAH & GT; 30).
During the follow -up, 1,017 (11.7%) patients developed diabetes.In the analyzes, they were adjusted by known risk factors for diabetes, including age, sex, body mass index, neck circumference, smoking, income level and comorbidity (diabetes associated with diabetes) at the beginning of the study.They discovered that:
patients with an IAH & GT;30 had 30% more risk of developing diabetes than those with an IAH & Lt; 5.
Patients with mild or moderate renal insufficiency of sleep had 23% more risk of developing diabetes.
Other risk factors for diabetes include IAh in rapid sleeping eyes and measurements of the physiological consequences of sleep apnea, including oxygen deaturation, lack of sleep and activation of the sympathetic nervous system, as indicated as it indicatesA higher average frequency of the heart during sleep.
Significant association between diabetes risk and sleep apnea
"After adjusting for other possible causes, we have been able to demonstrate a significant association between the severity of sleep apnea and the risk of developing diabetes," said Dr. Kendzerska.
“Our findings that the prolonged oxygen desaturation, the shortest sleep time and a greater heart rate and that were associated with diabetes are consistent with the pathophysiological mechanisms that it is believed that the basis of the relationship between sleep apnea anddiabetes."
The study had some limitations, such as the lack of data on some possible factors, including family history of diabetes and race, and the possible erroneous classification of some subjects, due to the limitations of the administrative health data used.
"The predictors related to the sleep apnea increased the risk of diabetes that we find in our study can allow early preventive interventions in these patients," said Dr. Kendzerska.Fountain:
Tetyana Kendzerska, Andrea S. Gershon, Gillian Hawker, George Tomlinson, Richard S. Leung.Obstructive Sleep Apnea and Incident Diabetes: A Historical Cohort Study.American Journal of Respiratory and Critical Care Medicine, 2014;140604084050003 DOI: 10.1164/RCCM.201312-2209OC
