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OSA affects two out of three people with type 2 diabetes.

Men over age 65 with type 2 diabetes have a 67% chance of having sleep apnea; for women over 65 the risk is nearly 50%. Untreated sleep apnea increases stress on your body, and in turn this causes blood sugar levels to rise. So it’s especially important for people with type 2 diabetes to recognize sleep apnea and have it treated.There is a direct relationship between weight gain in adulthood and the risk of Type 2 Diabetes Mellitus. Obese individuals are more likely to have both OSA and diabetes.  From 1959 to 2002, double the number of people are sleeping less than 7 hours per evening than ever before and the rate at which we see type 2 diabetes has escalated. That's a far cry from a clear cut cause and effect relationship, but it merits further investigation.  There is a 'which came first' relationship between sleep deprivation and Type 2 diabetes. 

An intriguing study was published in The Lancet in 1999, suggesting the link between sleep deprivation and type 2 diabetes. In this study researchers changed the sleep patterns of healthy young people to determine what, if any impact it would have on their ability to use glucose. These healthy individuals had been carefully screened to exclude anyone with even a possibility of diabetes. They were brought to live in a monitored lab and allowed to sleep only 4 to 6 hours a night. By the end of one week these previously healthy individual's bodies used glucose differently.  Researchers described the subject's use of glucose to be more consistent with that of elderly patients as compared to young healthy individuals. We don't fully understand how sleep -or the lack of sleep- impacts our ability to use glucose, but clearly a connection exists.

In 2006 a paper published in the Archives of Internal Medicine found that diabetics who reported poor sleep quality had a higher average blood glucose over 2 to 3 months versus those who reported they had better sleep quality.

In another study in the Proceedings of the National Academy of Sciences (2008), experimenters found that the quality of sleep, not just the amount of sleep, is critical.  Participants received a normal amount of total and REM sleep, but their slow-wave time was restricted. This led to metabolic changes in the participants that increased their risk of diabetes.

Sleep, Sleep-Disordered Breathing and Metabolic Consequences, published in July 2009 by Levy, Bonsignore and Eckel in the European Respiratory Journal also focused on the impact sleep has on metabolic pathways. Healthy test subjects who agreed to experimental sleep restriction experienced insulin resistance and increased evening cortisol and sympathetic activation. These authors speculated as to whether as a society's tendency to sleep less has led to an increase in obesity. The question is impossible to answer but it is clear there is a connection between sleep, diabetes, and weight. 

A study published Diabetes Care (2010) outlined a link between those with sleep disorders—difficulty falling or staying asleep, sleeping fewer than five to six hours a night or more than eight to nine hours and an increased risk of Type 2 diabetes.

A great amount of research is being done at this time to attempt to uncover the molecular basis for the connection between sleep and type 2 diabetes, but that doesn’t mean that a better night's sleep isn't important right now to aid in preventing and treating the disease.


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