Sleep Apnea in Type 2 Diabetes

Doumit, Jimmy; Prasad, Bharati

doi:10.2337/diaspect.29.1.14

Cited by 33 publications

(27 citation statements)

References 71 publications

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“…Emerging evidence indicates that the risk of developing diabetes associated with sleep disturbances, such as OSA, is comparable to traditional risk factors [22]. Moreover, many diabetic patients are at risk of developing OSA [23]. Our study aimed to assess endothelial function when both conditions are combined, as these are independent risk factors for CVD.…”

Section: Discussionmentioning

confidence: 99%

Uncoupling of Vascular Nitric Oxide Synthase Caused by Intermittent Hypoxia

Badran

Abuyassin

Golbidi

et al. 2016

Oxidative Medicine and Cellular Longevity

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Objective. Obstructive sleep apnea (OSA), characterized by chronic intermittent hypoxia (CIH), is often present in diabetic (DB) patients. Both conditions are associated with endothelial dysfunction and cardiovascular disease. We hypothesized that diabetic endothelial dysfunction is further compromised by CIH. Methods. Adult male diabetic (BKS.Cg-Dock7 m +/+ Lepr db/J) (db/db) mice (10 weeks old) and their heterozygote littermates were subjected to CIH or intermittent air (IA) for 8 weeks. Mice were separated into 4 groups: IA (intermittent air nondiabetic), IH (intermittent hypoxia nondiabetic), IADB (intermittent air diabetic), and IHDB (intermittent hypoxia diabetic) groups. Endothelium-dependent and endothelium-independent relaxation and modulation by basal nitric oxide (NO) were analyzed using wire myograph. Plasma 8-isoprostane, interleukin-6 (IL-6), and asymmetric dimethylarginine (ADMA) were measured using ELISA. Uncoupling of eNOS was measured using dihydroethidium (DHE) staining. Results. Endothelium-dependent vasodilation and basal NO production were significantly impaired in the IH and IADB group compared to IA group but was more pronounced in IHDB group. Levels of 8-isoprostane, IL-6, ADMA, and eNOS uncoupling were ≈2-fold higher in IH and IADB groups and were further increased in the IHDB group. Conclusion. Endothelial dysfunction is more pronounced in diabetic mice subjected to CIH compared to diabetic or CIH mice alone. Oxidative stress, ADMA, and eNOS uncoupling were exacerbated by CIH in diabetic mice.

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Section: Discussionmentioning

confidence: 99%

Uncoupling of Vascular Nitric Oxide Synthase Caused by Intermittent Hypoxia

Badran

Abuyassin

Golbidi

et al. 2016

Oxidative Medicine and Cellular Longevity

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“…31 When an individual is not reaching the N3 stage of sleep or staying in this stage for an adequate amount of time, glucose and insulin regulation is altered. 32 Obesity has a cyclical relationship with poor sleep quality and hormone and metabolism regulation. 32 Overweight persons are at a higher risk for airway obstruction upon reaching N3 stages of sleep, resulting in poor regulation of metabolic hormones.…”

Section: Systemic Health Concerns Related To Poor Sleepmentioning

confidence: 99%

“…32 Obesity has a cyclical relationship with poor sleep quality and hormone and metabolism regulation. 32 Overweight persons are at a higher risk for airway obstruction upon reaching N3 stages of sleep, resulting in poor regulation of metabolic hormones. 28 To continue the cycle of poor sleep and obesity, individuals who are sleep deprived are more likely to make unhealthy food choices and consume more calories during the day in an effort to increase energy levels.…”

Section: Systemic Health Concerns Related To Poor Sleepmentioning

confidence: 99%

Recognizing Poor Sleep Quality Factors During Oral Health Evaluations

Schroeder

Gurenlian

2019

Clin Med Res

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Oral health practitioners routinely perform oral health assessments for the dental patient to determine if oral disease is present. Systemic health is often a contributor to oral health concerns. One area in particular that has a direct effect on oral structures and oral health is poor sleep quality and open mouth breathing. Sleep is a fundamental process of the human body, which regulates core biological functions. Sleep quality reflects a person's ability to fall asleep, stay asleep, and enter into the various rejuvenating sleep cycles for the full duration. A person who does not obtain quality sleep can exhibit a wide range of oral, systemic, and cognitive health problems. Obstructive sleep apnea, which historically has been considered an adult male disease, is being recognized more often in women children. Research suggests various oral malformations found in newborns and young children can manifest as obstructive sleep apnea in adults. Oral health professionals are in a position to recognize the relationship between sleep and health, identify sleep quality concerns in relation to oral health assessments, administer sleep quality assessments, and determine appropriate referrals for further sleep quality evaluation.

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“…25 Adiponectin, secreted by adipose cells increases insulin sensitivity but its levels are decreased in the milieu of hypoxia. 26 In cross-sectional analyses of obese people, severity or frequency of apnea or minimum oxygen saturation, not BMI as predictors of insulin resistance. [27][28][29] In a meta-analysis including 5953patients with OSA over a 2-16 years duration, there were 332 incident cases of T2DM.…”

Section: Pathophysiologymentioning

confidence: 99%