Sleeping, Snoring and Diabetes

1. What is the link between Diabetes and Sleep Disorders?
• Lack of sleep or poor quality sleep is clearly linked with poor control of diabetes
• Diabetes patients often have associated sleep problems that are not diagnosed or treated appropriately
2. What are the common sleep disorders associated with diabetes?
• Poor control of diabetes leads to increased urination at night which can disrupt sleep.
• Patients with diabetes are at increased risk of having Restless leg syndrome and Periodic Limb movements which creates an uneasy feeling in their legs which can cause insomnia (lack of sleep) or fragmented sleep pattern which leads to ‘non refreshing’ sleep.
• Although diabetes is not a direct risk factor for snoring and Sleep Apnea, these disorders often co-exist because obesity is a common factor for both these problems.
3. What is snoring?
• Snoring is caused due to reduction in flow of air through the upper airway. Most often it is not associated with a structural obstruction and is caused due to collapse of upper airway muscles.
• Snoring is not a laughing matter and could be a warming signal of underlying Sleep Apnea.
4. What is Sleep Apnea?
• Sleep Apnea is a common, but under diagnosed problem which is present in 2-4% of the general population.
• The commonest presenting symptoms of Sleep Apnea are snoring and irregular breathing at night along with daytime fatigue and sleepiness.
• Most often patients are unaware of the fact that they snore or stop breathing at night, but spouses and others who witness are worried and disturbed by these symptoms.
• Daytime sleepiness and fatigue may be eventually lead to poor work performance, work related accidents and also road traffic accidents. Such patients are often branded as ‘lazy or incompetent’ when in fact their symptoms are due to a treatable medical problem.
5. How is Sleep Apnea diagnosed?
• Not all who snores may have Sleep Apnea.
• The only way to make a clear diagnosis of Sleep Apnea is to undergo a sleep study (polysomnograph) which is a test done overnight when various parameters including brain wave patterns, snoring and breathing patterns, oxygen levels, heart rate and leg movements during sleep are monitored to diagnosed and assess the severity of the problem.
6. How do we treat Sleep Apnea?
• Simple ‘Sleep hygiene’ measures like diet and exercise for weight loss, sleeping on the side, early and light dinner, avoidance of smoking, alcohol and caffeine would help.
• There are no medications to treat Sleep Apnea
• Mild Sleep Apnea is often treated with sleep hygiene measures and/or special oral appliances which are customized and created by prosthodontists.
• Moderate or severe Sleep Apnea can be treated with special devices called Continuous Positive Airway Pressure (CPAP) or surgery.
7. What is the relationship between Sleep Apnea and Diabetes?
• Obesity which is a common underlying risk factor can lead to Diabetes (TypeII), Sleep Apnea, Hypertension and heart disease.
• Patients with untreated Sleep Apnea will have poor control of diabetes and hypertension, but the good news is that treatment will improve control.
Source: Dr N Ramakrishnan
Director, Nithra Institute of Sleep Science

Looking at these scenarios MV Hospital for Diabetes and Diabetes research centre in collaboration with ‘Nithra Institute of Sleep Science’ has recently launched an exclusive diagnostic facility for Sleep Disorders among diabetics. This is the first diabetic centre in India to bring this specialty to the reach of many diabetics. The rapid changing lifestyle and eating habits has led to a spurt in obesity which has increased the occurrence of diabetes. So with MV Hospital’s increased focus on treatment of Type 2 diabetes, the launch of diagnostic lab is a welcome move for many patient belonging to this segment of diabetes.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website

KNOW ABOUT THE MOST IMPORTANT TEST FOR DIABETES CONTROL

Diabetes Mellitus, a chronic disease characterized by hyperglycemia of the eyes, heart, kidneys, blood vessels and other organ systems. The disease is accompanied by carbohydrate, lipid & protein metabolism disturbances.

Traditional methods of assessing glycemic control in diabetes such as taking a medical history, performing a physical examination and measuring blood and urine glucose, while extremely important for routine care have only limited value as indices of long term glycemic status.

It is only with the development of glycated Hb (GHb) testing that accurate, objective measure of long term glycemic status is possible.

The terms “glycated hemoglobin” also called glycohemoglobin or glycosylated Hb – refers to a series of stable minor Hb components that are formed slowly and non- enzymatic ally from Hb and glucose.

Of the fast moving Hb’s identified in the 1950’s, HbA1C is present in greatest quantity in both normal and diabetic individuals. HbA1C is formed by the non-enzymatic glycation of free amino groups at the ‘N’ terminal of the amino acid valine of the Hb “B” chain. The glucose remains bound during the erythrocyte life cycle. It is related to the degree of blood glucose level elevation and the time interval over which this occurs as well as the erythrocyte life span.

The HbA1C level correlates with the mean glucose concentration prevailing in the course of the patient’s recent history (approximately 6-8 weeks). Therefore provides much more reliable information for glycemic monitoring than do determination of blood glucose or urinary glucose.

Normal reference range is 4.3 to 6.0 %. However, good control for a diabetic patient is considered as, an HbA1C value below 7.0 %.

Glycohemoglobin is a valuable tool for assessing glycemic control and is routinely used in the care of persons with diabetes. Measurement of GHb has also shown useful research applications facilitating studies requiring objective assessment of long term glucose control. Reports have shown that regular monitoring of GHb among diabetic patients can facilitate changes in treatment schedule resulting in improved glycemic control.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website