Type 2 Diabetes and High Blood Pressure Patients Need Sleep Doctors
If you have type 2 diabetes or high blood pressure (or both), some experts say you need to add a doctor visit to your list of things to do. At the annual gathering of international experts for SLEEP 2013, it’s been recommended such patients consult a sleep doctor regarding evaluation for obstructive sleep apnea.
What’s so important about obstructive sleep apnea?
Obstructive sleep apnea is a serious condition in which a person’s throat muscles intermittently relax and obstruct the airway during sleep, resulting in repeatedly interrupted breathing. Snoring is the most common sign of obstructive sleep apnea.
Although anyone can develop obstructive sleep apnea, it is most common among middle-aged people, individuals who are overweight, and patients with type 2 diabetes and/or high blood pressure. In fact, 70 percent of people with type 2 diabetes and 30 to 40 percent of those with hypertension have obstructive sleep apnea.
How can a sleep disorder affect diabetes and blood pressure? Obstructive sleep apnea has a direct impact on blood glucose levels and sensitivity to insulin, and also can cause blood pressure to rise.
According to M. Safwan Badr, MD, president of the American Academy of Sleep Medicine, “Diagnosis and treatment of sleep apnea from a board-certified sleep medicine physical will promote improvement in these conditions [type 2 diabetes and hypertension]—including improved insulin sensitivity, blood pressure and cholesterol.”
Treatment of obstructive sleep apnea also has been shown to improve daytime function, especially memory, alertness, and the ability to think clearly and reason.
How is obstructive sleep apnea treated?
Obstructive sleep apnea can range from mild to severe, and there are various types of treatment, including lifestyle changes, that have been shown to be effective. For example:
- Lifestyle changes: mild cases of obstructive sleep apnea often respond to these positive lifestyle modifications: losing weight, eliminating alcohol use, stopping smoking, and not sleeping on your back
- Nasal decongestant: some patients find that adding a nasal decongestant to lifestyle changes is effective
- Mouthpiece: Some patients choose an oral device, or mouthpiece, that is designed to keep the throat open. There are several different types of mouthpieces for this purpose, and you will need to consult a dentist with expertise in sleep medicine devices to be fitted for the treatment
- Continuous positive airway pressure. Also known as CPAP, continuous positive airway pressure is a machine that delivers air pressure through a mask you place over your nose during sleep. The pressure of the delivered air is greater than the air around you, which keeps your upper airway passages open and thus prevents obstruction. Although CPAP is highly effective, some people find it to be uncomfortable. You can try several different types of CPAP or an alternative called bilevel positive airway pressure (BPAP).
- Surgery: A variety of surgical procedures also are available. They include surgical removal of tissue from the back of the mouth and top of the throat (uvulopalatopharyngoplasty), jaw surgery, implants (placement of rods in the soft palate to reduce upper airway collapse and snoring), surgical removal of polyps in the nasal passages, and surgical removal of enlarged tonsils or adenoids.
Previous research shows that treatment of obstructive sleep apnea (e.g., CPAP) in patients with type 2 diabetes can have a significant positive effect on blood glucose, while the same can be said for individuals with high blood pressure who receive treatment. Given the high percentage of patients with type 2 diabetes or high blood pressure who also have obstructive sleep apnea and the benefits of treatment, it has been recommended that individuals with these conditions see a sleep doctor for an evaluation.
American Academy of Sleep Medicine