Breathing problems during sleep may be common in patients with type 1 diabetes

This study examined the prevalence of obstructive sleep apnea (OSA) in patients with type 1 diabetes (T1D). It was concluded that patients with T1D were more likely to have OSA than the general population.

Obstructive sleep apnea (OSA) is a disorder where breathing either stops or is slowed during sleep. This can reduce the level of oxygen in the body. OSA can lead to fatigue and sleepiness during the day. In severe cases OSA can increase cardiovascular risk. 

OSA has been found to have a very high prevalence in patients with type 2 diabetes. Evidence on the prevalence of OSA in patients with T1D is currently limited. 

199 patients with T1D were recruited from a clinic in Denmark. The patients were all over 18 years of age, and had been diagnosed with T1D at least one year previously. A device was used at home that detected the presence of apnea during sleep. Patients who were found to have mild or moderate OSA were referred to a sleep specialist for confirmation of the diagnosis.

Information about patients’ vision, nervous system function, body mass index (BMI; a measure of weight that takes height into account), HbA1c (average measure of blood glucose over the last 3 months) and cholesterol levels was collected from patient records and interviews. A questionnaire was also used to assess the patients’ symptoms of sleepiness, as these have been found to increase with OSA.

92 out of 199 (46%) of patients in the study were found to have OSA. Mild OSA was the most common (31%). 8% of patients had moderate OSA, and 6% had severe OSA. Patients with OSA were found to have a lower concentration of oxygen in their blood.

Patients with OSA did not report more sleepiness than those without OSA, but were more likely to report snoring. They were more likely to be male, were older with a longer duration of diabetes, had a higher BMI, and higher blood pressure. Patients with OSA were also more likely to have nerve and/or kidney damage. 

This study concluded that patients with T1D had a high prevalence of OSA. 

The participants recruited for this study were more likely to have sleep related problems, were mostly men (68%) and tended to be older. These factors may have had an influence on the results.

Furthermore, estimates of the prevalence of OSA in the general population tend to vary. If this group had been compared to a similar group of patients without T1D, that would have helped to put the results in context. 

Discuss testing for OSA with your physician, especially if you have any of the following additional risk factors; high BMI, older than 40 years, and/or have already experienced medical complications related to T1D.