Type 2 diabetes and sleep apnea are two conditions that are hard to live with. And the worst part is that you can be a type 2 diabetic and have obstructive sleep apnea, both without knowing it.
If you have type 2 diabetes you are in a state of insulin resistance. There is no known cure for it. Diabetes and sleep apnea have this in common.
Obstructive Sleep Apnea, Silent Killer
One third of men with type 2 diabetes also have this sleep disorder. In men older than 60 the number becomes almost two thirds. Among women the number is less, about one half.
If you snore at night and you are observed to stop breathing and then gasp for air or cough, that is obstructive sleep apnea (OSA) at work. There are several things going on in your throat to cause the obstruction.
Relaxed throat muscles, a larger or longer uvula (the thing that dangles at the back of your throat), a large tongue that falls back into your throat as you sleep, these are problems that go along with obstructive sleep apnea.
Your condition can be mild, moderate or severe based on those things as well as on fat deposits in your neck. The more fat you have stored around your abdomen, the worse the sleep disorder is likely to be.
Because you can have sleep apnea without knowing it, the problem will continue for years untreated. That is why it is a silent killer. Going for seconds and even minutes without breathing at night puts stress on your heart.
High blood pressure that does not respond to medication, strokes, and increased insulin resistance are some of the things that can happen. And insulin resistance is what links diabetes and sleep apnea.
Obstructive sleep apneic events waken you over and over, sometimes hundreds of times a night, and the deep sleep you need isn’t happening. This is especially true if your condition is moderate to severe.
Sleepiness through the day at work and while driving has led to accidents both on the job and while driving. So dying in an accident and dying at night because they did not wake up during an apneic event are two of the worst consequences of OSA.
What Are the Chances You Have Diabetes and Sleep Apnea?
Of the type 2 diabetics tested in one research study, 36% had OSA and did not know it. That’s over a third. That means all of those people may have had unexplained fatigue, depression and reduced insulin sensitivity.
They probably blamed it on their type 2 diabetes and sleep apnea was the real cause. The strange thing researchers have discovered is that being more or less overweight does not affect your risk of having the sleep disorder.
When type 1 diabetic children were tested for sleep apnea, it was found in one-third of them as well. And they had it no matter what they weighed. Type 1 diabetics suffer from the complications of fatigue and depression from lighter sleep as well as higher blood sugars, just like type 2 diabetics do.
What You Can Do About It
One doctor said treating obstructive sleep apnea would do more for a diabetic than any other treatment to improve blood sugar levels. The reason? Treating OSA lowers insulin resistance and the stress levels that are causing blood sugar to rise and be difficult to control.
People who are treated successfully for OSA get better blood pressure control, better blood sugar readings, and the fatigue and depression from lack of deep sleep are gone as well. Treating diabetes and sleep apnea together helps both.
For mild to moderate symptoms of OSA, tongue and soft palate exercises can help. The tongue exercises are things like trying to touch your chin with your tongue, and wagging it from side to side as far as you can.
For the soft palate you can try gargling as loud as you can using warm water. If these things sound silly to you, they come straight from the American Journal of Respiratory and Critical Care Medicine.
Other things you can try involve your sleep position. You need to avoid sleeping on your back. If that is hard for you, make a pocket in the back of your pajamas and put a tennis ball in it so you won’t want to roll over on your back. Or use pillows to prop yourself on your side.
Losing weight can help too. Don’t drink alcohol at night or take drugs that relax your muscles. And stop smoking. These things have been shown to help mild sleep apnea.
But if you have severe OSA you will probably do best with a CPAP. It’s a continuous positive airway pressure machine, usually about the size of a small humidifier with a tube leading to a mask you have to wear.
It delivers pressured air that blows into your nose and/or mouth. This actually stops most snoring and apnea events. The level of pressure is adjusted to fit your needs based on testing a sleep doctor does.
The CPAP has some downsides. It takes time to get used to sleeping with it, and finding the proper fitting mask for your face can be hard. And the blowing air causes stuffy nose and headaches, though using an attached humidifier can help. The contraption can irritate your face too.
But the biggest problem is the cost. Sleep doctors use expensive equipment and guages for oxygen levels and measuring your time at different stages of sleep. Then special machines tell them what air pressure you will need after they have counted your apnea attacks and decided you need CPAP.
The test takes all night, but it is necessary to document moderate to severe sleep apnea before insurance will pay for it. There are machines that will test in your own home, but they are still new, and often you’ll need confirmation and adjustment in a doctor’s office.
But the results of this treatment for diabetes and sleep apnea are well documented. CPAP does improve and even end OSA as long as it is being used. It doesn’t cure sleep apnea though, so you will have to continue to use the machine.
Sometimes weight loss and lifestyle changes can stop the symptoms of diabetes and sleep apnea as well. And sometimes surgery helps, but the results of throat and tongue surgery are often disappointing.
The clamps, jaw braces and other things that are supposed to keep your airway open at night, as well as jaw surgeries, can be a waste of money. They often just don’t work.
Finding Out Is the First Step
Finding out if you have diabetes and sleep apnea together is the best starting point. If you notice fatigue, lack of energy, sleepiness during the day, and if you snore and others say you stop breathing at night, it’s sleep apnea.
Diabetes and sleep apnea will plague you whether you know about them or not, and lifestyle changes with a good diet, exercise and treatment of sleep apnea are going to improve your quality of life. Who knows? You might be able to take less insulin and other medications.
Anything that makes your type 2 diabetic condition easier to treat is a plus. That’s why discovering diabetes and sleep apnea, and their connection to insulin resistance, is important.
It may give you a better chance to do the things you care about and live to see the fruits of your dreams. It’s what I’m hoping for all of us.
Martha Zimmer invites you to visit her website and learn more about type 2 diabetes, its complications and how you can deal with them, as well as great tips for eating healthy that will make living with diabetes less painful.
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