Sleep Apnea and Diabetes : A Troubling Relationship

Affecting around half of all diabetics, obstructive sleep apnea (OSA) is a sleep disordered breathing condition that is linked to a variety of other serious health problems, including diabetes. The relationship between sleep apnea and diabetes has been a point of connection for medical professionals for several decades.

As people with diabetes have been reported as having a higher incidence of sleep breathing disorders since the early 1980s, researchers have been working to discover the link and determine the best way to treat both of the interconnected conditions.

About Sleep Apnea

Sleep apnea is a condition in which the breathing passages become blocked at various times throughout sleep, causing pauses in breathing which result in oxygen deficiency. Because of this, the brain has to “start” the body awake by releasing hormones. Over time, sleep apnea can result in a variety of serious health conditions including heart problems, sleep deprivation, relationship problems, weight gain, stroke, and even premature death.

Signs and Symptoms of Sleep Apnea include:

  • Loud snoring
  • Waking up with a headache
  • Occasionally waking with a sensation of choking, coughing, or gasping
  • Insomnia or trouble staying asleep
  • Fatigue or excessive daytime sleepiness
  • Falling asleep during activity such as driving or at work
  • Observed pauses in breathing during sleep
  • High blood pressure
  • Poor work performance, memory loss, and difficulty concentrating
  • Relationship struggles, difficulty communicating, and depression
  • Decreased libido

About Diabetes

Diabetes is a metabolic disorder in which the body is unable to produce or respond to insulin in the appropriate manner. When your pancreas is unable to produce or regulate this needed hormone, serious complications can result including problems with the heart and kidneys, as well as potential blindness and possible loss of digits or lower limbs.

Signs and Symptoms of Diabetes include:

  • Frequent urination
  • Increased appetite (even after eating)
  • Increased thirst
  • Dry mouth
  • Fatigue
  • Headaches
  • Blurred vision
  • Itchy skin
  • Weight gain or weight loss
  • Tingling or numbness in the feet and hands
  • Cuts or sores healing more slowly than usual

Does Sleep Apnea Cause Diabetes?

The question about which of these medical conditions causes the other is complicated. What is known is the fact that diabetes is definitively linked with obesity—and being overweight is a high risk factor for sleep apnea. Because people who are obese carry extra fat and tissue in their neck areas, a stronger likelihood exists that their breathing passages will be blocked during sleep and lead to sleep apnea.

Even in people who are not obese, the likelihood of developing diabetes is stronger if they leave obstructive sleep apnea untreated. Many experts suspect that the lack of oxygen caused by sleep apnea leads to hypoxia, which causes the brain to send messages to the body to increase the function of the respiratory system. When the body cannot breathe (because the airways are blocked), stress hormones such as adrenaline and cortisol are released. These stress hormones create a reaction that starts the person awake in order to restore breathing.

When people who have sleep apnea experience these start awakenings often throughout the night for months or years at a time, eventually this regular release of hormones can result in raised levels of blood sugar and an inability for the body to remain sensitive to insulin. Left unchecked, these insulin and blood sugar levels act as dominoes which ultimately can lead to insulin resistance, glucose intolerance, and eventually diabetes.

Does Diabetes Cause Sleep Apnea?

In general, people with diabetes tend to experience poorer sleep than those in the general population, although no one is quite sure why. The cycle of questions continues about whether diabetes causes sleep problems, or sleep problems cause diabetes.

Evidence suggests that diabetes may be a contributing cause of sleep disordered breathing, especially for people who are obese or excessively overweight. The link between obesity and diabetes is well-known, and people who are overweight often have extra fatty tissue in their neck which blocks the airways and disrupts regular breathing during sleep causing sleep apnea.

One study has shown that diabetics struggle with resistance to leptin, a hormone which stabilizes breathing patterns during sleep and reduces the effectiveness of the respiratory system. Leptin also triggers a feeling of being “full”, so people with diabetes may have a tendency to overeat which leads to obesity—and could eventually result in diabetes. This resistance to leptin could be one explanation of why diabetics seem to have a predisposition to sleep apnea.

Diagnosis and Treatment for Sleep Apnea

Although having obstructive sleep apnea does not guarantee a future diagnosis of diabetes, and having diabetes does not guarantee a diagnosis of sleep apnea, the two certainly create risk factors for one another. Anyone who thinks they may be at risk of either condition should see a doctor, of course. But someone who already has one of these conditions diagnosed should be particularly vigilant about paying attention to signs that might indicate the development of the other.

For instance, a person with diabetes should be aware of loud snoring, weight gain, high blood pressure, and other signs that they may be developing sleep apnea. If you are concerned that you or someone in your life may have sleep apnea, a doctor will likely perform a sleep study to secure a diagnosis and narrow down treatment options. Treatment will depend on the cause of the sleep apnea as well as the severity of the condition.

Sleep apnea can often be treated in a fairly simple, non-invasive manner. A Continuous Positive Airway Pressure (CPAP) machine is often indicated to help with breathing during sleep and restore the body to healthy sleep patterns. Even better, some people find that treating their sleep apnea allows them to sleep better, eat healthier, exercise more, and eventually lose weight. This weight loss can also contribute to managing the conditions for people who have both sleep apnea and diabetes.


While both sleep apnea and diabetes are serious conditions that certainly require you to be under the care of a doctor, they are also treatable. Following the advice of your medical professional for sleep, diet, and healthy lifestyle changes can offer you a new sense of energy, making you feel healthier than you have in years and restoring your life to more of what it should be.

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