People with type 2 diabetes could be at a greater risk of developing obstructive sleep apnea (OSA), independent of other factors, research suggests.
OSA occurs when the walls of the throat relax and narrow during sleep. Symptoms usually include loud snoring, noisy and laboured breathing and repeated short periods where breathing is interrupted by gasping or snorting.
OSA has long been associated with an increased risk of developing type 2 diabetes, so researchers sought to investigate this link further.
The University of Birmingham study involved looking at health data from between January 2005 and December 2017 of people with OSA and compared those with type 2 diabetes to those who did not.
By using the Health Improvement Network (THIN), a primary care database, the research team found 1,296,489 people who had type 2 diabetes and 360,250 who did not.
The researchers’ findings indicate that the association between type 2 diabetes and OSA is bidirectional. This means that the study suggests that type 2 diabetes may encourage the development of OSA, and OSA may encourage progression of type 2 diabetes.
Out of the risk factors for OSA reviewed by the study, obesity was the most significant. Obesity conferred an eight times greater risk of OSA. This compared with a two times greater risk for people that were overweight but not obese.
Being male, having been prescribed insulin recently, having depression and having diabetes-related foot disease were among other factors identified with greater risk of OSA.
The researchers state that understanding the complex relationships between OSA and type 2 diabetes is key as OSA may be a risk factor that can be modified to reduce the impact on type 2 diabetes. By extensio, type 2 diabetes appears to be a risk factor in OSA.
The findings have been published in the Diabetes Care journal.

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