Obstructive sleep apnoea and diabetes

Tahrani, Abd A; Ali, Asad; Stevens, Martin J.

doi:10.1097/mcp.0b013e3283659da5

Cited by 50 publications

(63 citation statements)

References 116 publications

(46 reference statements)

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“…28,[30][31][32] In General Population Studies Several cross-sectional studies showed an association between OSA and IR but some studies did not show such an association. 7,10,11 Obesity is obviously a major confounder but the association between OSA and IR was also found in lean individuals, suggesting that the relationship is independent of obesity. 33,34 One study examined the effect of OSA on IR longitudinally; over 11-year follow-up OSA, AHI, oxygen desaturation index (ODI) and minimal oxygen saturations overnight were independently associated with IR after adjustment for age, baseline BMI, hypertension, BMI change over follow-up and CPAP treatment.…”

Section: Obstructive Sleep Apnoea and Insulin Resistancementioning

confidence: 99%

“…7,8 OSA is characterised by upper airway instability during sleep that results in recurrent upper airway obstruction resulting in either complete or partial cessation of airflow (i.e. apnoea and hypopnoea, respectively).…”

Section: Introductionmentioning

confidence: 99%

“…7,10,11 In this article the evidence of the relationship and impact of OSA on vascular disease and CVD risk factors will be reviewed, particularly in patients with T2D.…”

mentioning

confidence: 99%

“…9 Several large epidemiological studies and randomised controlled trials (RCTs) have shown that OSA was associated with CVD and CVD risk factors in general populations, while the impact of OSA on vascular disease in patients with T2D has only gained attention in the last few years. 7,10,11 In this article the evidence of the relationship and impact of OSA on vascular disease and CVD risk factors will be reviewed, particularly in patients with T2D.…”

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confidence: 99%

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Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

Tahrani¹

2015

US Endocrinology

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Obstructive sleep apnoea (OSA) is common and is associated with many vascular risk factors, such as hypertension, insulin resistance, albuminuria, dyslipidaemia, increased inflammation and endothelial dysfunction. Epidemiological studies have shown that OSA is associated with increased cardiovascular disease (CVD) and that continuous positive airway pressure (CPAP) might reduce CVD events in patients with OSA. In addition, OSA has also been shown to be associated with albuminuria, chronic kidney disease, a wide range of ocular diseases and peripheral neuropathy. Considering that CVD and microvascular complications are major contributors to the morbidity, mortality and the economic burden of diabetes and that OSA is common in patients with type 2 diabetes (T2D), it is important to understand the role of OSA in the development and/or progression of vascular disease in patients with T2D and to explore the impact of CPAP on diabetes-related vascular outcomes. The purpose of this article is to review the evidence for the relationship and impact of OSA on vascular disease and vascular risk factors particularly in patients with T2D. KeywordsType 2 diabetes, obstructive sleep apnoea, vascular disease, vascular risk Diabetes-related macro-and microvascular complications contribute significantly to the increased morbidity, mortality, worsened quality of life and social and financial burden observed in patients with diabetes. [1][2][3][4][5] Hence, reducing the development and/or the progression of these complications is one of the main aims of treatment in patients with diabetes.Over the last 2 decades, strategies resulting in the improvements of glycaemic control, blood pressure (BP) and lipids and the use of renin angiotensin aldosterone inhibitors, resulted in reductions in cardiovascular disease (CVD) in patients with diabetes, but there was little impact on diabetic microvascular complications. 6 Nonetheless, both CVD and microvascular complications remain common and a better understanding of the pathogenesis of these complications is needed in order to identify new treatment strategies.Obstructive sleep apnoea (OSA) is common in patients with type 2 diabetes (T2D) (up to 86 % prevalence), which is not surprising considering that increasing age and obesity are common risk factors to both conditions. 7,8 OSA is characterised by upper airway instability during sleep that results in recurrent upper airway obstruction resulting in either complete or partial cessation of airflow (i.e. apnoea and hypopnoea, respectively). 9The recurrent obstructions of the upper airway usually result in recurrent oxygen desaturations/re-saturations, cyclical changes in intrathoracic pressure (as the patient attempts to breath against a blocked airway) and recurrent micro arousals that cause sleep fragmentation and reduction in slow wave and rapid eye movement (REM) sleep and result in termination of the apnoea/hypopnoea episodes. 9Several large epidemiological studies and randomised controlled trials (RCTs) have shown that OSA was ...

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Section: Obstructive Sleep Apnoea and Insulin Resistancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…7,10,11 In this article the evidence of the relationship and impact of OSA on vascular disease and CVD risk factors will be reviewed, particularly in patients with T2D.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

Tahrani¹

2015

US Endocrinology

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“…The growing prevalence of obesity and the increasing population body mass index has created major public health challenges [11] . Obstructive sleep apnea has been independently linked with hypertension, atrial fibrillation, cardiac disease, worsening of diabetes, insulin resistance, peri-operative and postoperative complications and coronary artery disease (CAD), to name the few [12][13][14][15][16] .…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?

Surani

2014

WJD

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Obesity, sleep apnea, diabetes and cardiovascular diseases are some of the most common diseases encountered by the worldwide population, with high social and economic burdens. Significant emphasis has been placed on obtaining blood pressure, body mass index, and placing importance on screening for signs and symptoms pointing towards cardiovascular disease. Symptoms related to sleep, or screening for sleep apnea has been overlooked by cardiac, diabetic, pulmonary and general medicine clinics despite recommendations for screening by several societies. In recent years, there is mounting data where obesity and obstructive sleep apnea sit at the epicenter and its control can lead to improvement and prevention of diabetes and cardiovascular complications. This editorial raises questions as to why obstructive sleep apnea screening should be included as yet another vital sign during patient initial inpatient or outpatient visit.

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Diabetes and sleep apnea

Tahrani

2015

International Textbook of Diabetes Mellitus

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Obstructive sleep apnoea and diabetes

Cited by 50 publications

References 116 publications

Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?

Diabetes and sleep apnea

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