Sleep apnea has long been known to be associated with obesity, but a new study found that the disorder is widely undiagnosed among obese individuals with Type 2 diabetes.
Nearly 87 percent of the participants reported symptoms but were never diagnosed, according to the study, published in the June issue of Diabetes Care.
For those with untreated sleep apnea, it doesn't just mean their sleep is disrupted; existing research shows that it also can mean an increased risk of heart disease and stroke.
"The high prevalence of undiagnosed, and therefore, untreated sleep apnea among obese patients with diabetes constitutes a serious public health problem," said Gary Foster, lead author and director of the Center for Obesity Research and Education at Temple University.
The study, called Sleep AHEAD, looked at 306 obese patients with Type 2 diabetes already enrolled in the Look AHEAD trial, a 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5,145 overweight or obese adults with Type 2 diabetes.
Each participant had a sleep study (polysomnogram), which measures various breathing and brain activity during sleep. Participants also answered questions about symptoms related to sleep (snoring, sleepiness during the day). Their weight, height, waist, and neck circumferences also were measured.
Researchers found that 86.6 percent of participants had sleep apnea, yet reported never being diagnosed. More than 30 percent of these had between 16 and 20 episodes an hour in which they would stop breathing, and 22 percent had more than 30 episodes an hour, considered severe sleep apnea. Most of these also had a larger waist circumference, which researchers found, along with higher BMI, to be significantly associated with sleep apnea.
Obesity has long been known to be associated with sleep apnea, but researchers say that these findings are alarming.
"Doctors who have obese patients with type 2 diabetes need to be aware of the possibility of sleep apnea, even if no symptoms are present, especially in cases where the patient has a high BMI or waist circumference," said Foster.
More than half of obese or overweight individuals have diabetes, the seventh-leading cause of death in the United States.
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