A study results found that there is a statistically significant association between type 2 diabetes and obstructive sleep apnea (OSA) during REM sleep.
Principle investigator Dr. Kamran Mahmood said, Type 2 diabetes is a multifactorial disorder. REM-related OSA and its metabolic effects need to be investigated in more depth, and this can provide another unique avenue for intervention and control of type 2 diabetes.
Dr. Mahmood and team from the University of Illinois in Chicago evaluated a multi-ethnic sample of 1008 patients, including Caucasians (16.9%), African-Americans (66.9%) and Hispanics (14.9%), for OSA using polysomnography.
The investigators found that the occurrence of type 2 diabetes was 30.1% in patients with OSA compared to 18.6% in patients without OSA.
The team reported that the OSA patients defined as an apnea-hypopnea index of 5 or more per hour showed increased unadjusted odds ratio for type 2 diabetes (odds ratio, 1.8) but this association became non-significant (OR, 1.3) in analyses controlled for BMI, age, and other covariables.
More over, middle-aged participants with OSA had 2.8-times higher odds for type 2 diabetes compared to younger or middle-aged participants without OSA, after controlling for covariables.
Additionally, compared to patients without OSA, the adjusted odds ratio for type 2 diabetes was 2.0 in patients with REM sleep-related OSA, defined as a REM apnea-hypopnea index of 10 or more per hour.
We believe that REM-related OSA is a marker of early OSA, especially in women and patients younger than 55 years, Dr. Mahmood noted in a prepared statement. Generally, OSA is worse in REM sleep compared to non-REM sleep because of neurologically-mediated impairment of skeletal muscles of upper airway and ventilation. This may be the reason for closer association of REM-related OSA and type 2 diabetes.