Prevalence of Diagnosed Sleep Apnea Among Patients With Type 2 Diabetes in Primary Care

Heffner, John E.; Rozenfeld, Yelena; Kai, Mari; Stephens, Elizabeth; Brown, Lee K.

doi:10.1378/chest.11-1945

Cited by 90 publications

(81 citation statements)

References 40 publications

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“…Weight loss can produce clinically relevant improvements in OSA among obese patients with diabetes that are sustained at 4 y. 26 The low reported rate of diagnosed OSA in a large primary care diabetes population of 18% 27 …”

Section: Discussionmentioning

confidence: 99%

Nocturnal Hypoxemia and Severe Obstructive Sleep Apnea are Associated with Incident Type 2 Diabetes in a Population Cohort of Men

Appleton

Vakulin

McEvoy

et al. 2015

Journal of Clinical Sleep Medicine

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BRIEF SUMMARYCurrent Knowledge/Study Rationale: The generalizability of fi ndings from the few studies that identify OSA as a risk factor for the development of diabetes may be limited by small samples, few incident cases, and possible referral bias that may apply to clinical samples. The importance of other polysomnographic measures (e.g., oxygen desaturation) and sleepiness in the development of diabetes is also unclear. Study Impact: The current study has identifi ed that severe undiagnosed OSA and nocturnal intermittent hypoxemia were independently associated with the development of diabetes in a large population cohort of middle-aged and older men. Given the scale of the problem of undiagnosed OSA, improved management is required to ensure that a patient presenting with one condition is screened and treated for the other with a strategy that does not rely on the presence of excessive daytime sleepiness. Study Objectives:Studies examining the longitudinal association of untreated obstructive sleep apnea (OSA) with diabetes in population samples are limited. This study therefore examined the relationship between previously undiagnosed OSA with incident type 2 diabetes in communitydwelling men aged ≥ 40 y. Methods: The Men Androgen Infl ammation Lifestyle Environment and Stress (MAILES) Study is a longitudinal population-based cohort in Adelaide, South Australia. Clinic assessments at baseline and follow-up identifi ed diabetes (self-reported doctor diagnosed, fasting plasma glucose ≥ 7.0 mmol/L, glycated hemoglobin ≥ 6.5% or diabetes medication use) and included anthropometry. At cohort follow-up (2010-2012), n = 837 underwent full in-home unattended polysomnography (PSG, Embletta X100, Broomfi eld, CO). Results: Of 736 men free of diabetes at baseline, incident diabetes occurred in 66 (9.0%) over a mean follow-up time of 56 mo (standard deviation = 5, range: 48-74 mo). Incident diabetes was associated with current oxygen desaturation index (3%) ≥ 16 events/h (odds ratio [OR]: 1.85 [1.06-3.21]), and severe OSA [OR: 2.6 (1.1-6.1)], in adjusted models including age, percentage total body fat, and weight gain (> 5 cm waist circumference). An age-adjusted association of incident diabetes with percentage of total sleep time with oxygen saturation < 90% did not persist after adjustment for percentage of body fat. No modifi cation of these relationships by excessive daytime sleepiness was observed. Conclusions: Severe undiagnosed OSA and nocturnal hypoxemia were independently associated with the development of diabetes. A reduction in the burden of undiagnosed OSA and undiagnosed diabetes is likely to occur if patients presenting with one disorder are assessed for the other. Keywords: cohort study, epidemiology, men, nocturnal hypoxemia, obstructive sleep apnea, polysomnography, type 2 diabetes Citation: Appleton SL, Vakulin A, McEvoy RD, Wittert GA, Martin SA, Grant JF, Taylor AW, Antic NA, Catcheside PG, Adams RJ. Nocturnal hypoxemia and severe obstructive sleep apnea are associated with incident type 2 diabetes i...

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Section: Discussionmentioning

confidence: 99%

Nocturnal Hypoxemia and Severe Obstructive Sleep Apnea are Associated with Incident Type 2 Diabetes in a Population Cohort of Men

Appleton

Vakulin

McEvoy

et al. 2015

Journal of Clinical Sleep Medicine

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“…8 The reported prevalence of OSA in patients with T2DM varies considerably between studies (8.5% to 86%). [9][10][11][12][13][14][15][16][17][18][19][20][21] These discrepancies may reflect differences in the population examined (such as the setting of care, sex, ethnicities, degree of obesity, etc. ), the methods used to diagnose OSA (such as questionnaires, portable home-based devices, polysomnography), and the parameters and definitions used to diagnose OSA (the apnea-hypopnea index (AHI) versus oxygen desaturation index (ODI), cutoffs of 5, 10 or 15 events/h).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Associations of Obstructive Sleep Apnea in South Asians and White Europeans with Type 2 Diabetes: A Cross-Sectional Study

Amin

Ali

Altaf

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives:To assess and compare obstructive sleep apnea (OSA) prevalence in South Asians and White Europeans with type 2 diabetes mellitus (T2DM). Secondary aims included exploring possible causes for observed ethnic differences. Methods: A cross-sectional study of patients with T2DM recruited from secondary care diabetes clinics. OSA was defined as an apnea-hypopnea index (AHI) ≥ 5 events/h using home-based, multi-channel respiratory monitoring. Results: Two hundred thirty-four patients (105 South Asian and 129 White Europeans) were studied. The prevalence of mild, moderate, and severe OSA in South Asians was 36.2% (n = 38/105), 9.5% (n = 10/105), and 5.7% (n = 6/105) respectively. After adjustment, OSA was associated with a higher body mass index in South Asians. OSA was significantly less common in South Asians compared to White Europeans Conclusions: South Asians with T2DM are at considerable risk of OSA. OSA in South Asians was associated with obesity. However, OSA prevalence was lower in South Asians than in White Europeans. Obesity measures accounted for the observed ethnic differences. Examining factors contributing to ethnic differences will be important to inform screening and treatment strategies. Keywords: ethnicity, obesity, sleep apnea, type 2 diabetes Citation: Amin A, Ali A, Altaf QA, Piya MK, Barnett AH, Raymond NT, Tahrani AA. Prevalence and associations of obstructive sleep apnea in South Asians and White Europeans with type 2 diabetes: a cross-sectional study.

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“…Other study shows that patients with comorbid obesity (BMI > 40) were 12 times probabilities of having OSA compared with normal weight patients (18.5-24.9) [14,19].…”

Section: Discussion:-mentioning

confidence: 99%

“…Untreated OSA complicates glycemic control and encourages diabetes, which, consecutively, alters respiratory control. [5] The under-recognition of OSA leads to 10 years delay between symptoms onset and referral to sleep centers in Saudi Arabia that was suggested by many studies caught our attention to this problem and the urgent need to do more researches in this field. [2] The aim of this study is to compare the risk of OSA between diabetic patients and non-diabetic middle aged Saudi population.…”

Section: Issn: 2320-5407mentioning

confidence: 99%

Risk of Obstructive Sleep Apnea in Patients With Type 2 Diabetes Mellitus.

Alghafli.¹,

Alshakhs.²,

Aljaber.³

2017

IJAR

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Prevalence of Diagnosed Sleep Apnea Among Patients With Type 2 Diabetes in Primary Care

Cited by 90 publications

References 40 publications

Nocturnal Hypoxemia and Severe Obstructive Sleep Apnea are Associated with Incident Type 2 Diabetes in a Population Cohort of Men

Nocturnal Hypoxemia and Severe Obstructive Sleep Apnea are Associated with Incident Type 2 Diabetes in a Population Cohort of Men

Prevalence and Associations of Obstructive Sleep Apnea in South Asians and White Europeans with Type 2 Diabetes: A Cross-Sectional Study

Risk of Obstructive Sleep Apnea in Patients With Type 2 Diabetes Mellitus.

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