Prevalence and recognition of obstructive sleep apnea (OSA) in Chinese with type 2 diabetes mellitus.
Summary of "Prevalence and recognition of obstructive sleep apnea (OSA) in Chinese with type 2 diabetes mellitus."
Obstructive sleep apnea (OSA) is associated with disorders of glucose metabolism. Previous studies revealed high prevalence of OSA among type 2 diabetes mellitus (DM) subjects. The aims of this study were to find out the prevalence of OSA and associated clinical factors in Chinese patients with DM. All records of the DM clinic at a teaching hospital in Hong Kong were screened between January 2007 and June 2008. Inclusion criteria were Chinese, age 18-75 years and type 2 DM. Patients with unstable medical illnesses, gestational diabetes or on renal replacement therapy were excluded. Of 3489 records screened, 1859 subjects were eligible. A random sample of 663 (mean age 58.2+/-10.8, mean BMI 26.0+/-4.6), except six with known OSA, were invited for polysomnography(PSG). Of 165 subjects with PSG performed, OSA was diagnosed (Apnea-hypopnea index[AHI] >/= 5.0/hr) in 89 subjects(53.9%, median Epworth Sleepiness Scale: 6 [3,10]). Fifty-four(32.7%) had moderate-severe OSA(AHI>==15/hr). The estimated OSA prevalence in this diabetic cohort was 17.5%(24.7% in men, 10.3% in women). Regression analysis identified that AHI was associated independently with higher BMI, advanced age, male gender and higher diastolic blood pressure(R(2)=29.6%). The adjusted odds ratio of requiring >/= three antihypertensive drugs in moderate/severe OSA was 2.48 (95% CI 1.05 - 5.87). No association with glycemic control(HbA1c) and sleep was identified. In conclusion, OSA is more prevalent in Chinese adults with DM than in the general population. A high index of suspicion for OSA in DM patients is warranted since they may not have overt daytime sleepiness. Trial registration: clinicaltrials.gov; Identifier: NCT00876980.
Affiliation
Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
Journal Details
This article was published in the following journal.
Name: Chest
ISSN: 1931-3543
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20705796
- DOI: http://dx.doi.org/10.1378/chest.10-0596
Medical and Biotech [MESH] Definitions
Sleep Apnea, Central
A condition associated with multiple episodes of sleep apnea which are distinguished from obstructive sleep apnea (SLEEP APNEA, OBSTRUCTIVE) by the complete cessation of efforts to breathe. This disorder is associated with dysfunction of central nervous system centers that regulate respiration. This condition may be idiopathic (primary) or associated with lower brain stem lesions; chronic obstructive pulmonary disease (LUNG DISEASES, OBSTRUCTIVE); HEART FAILURE, CONGESTIVE; medication effect; and other conditions. Sleep maintenance is impaired, resulting in daytime hypersomnolence. Primary central sleep apnea is frequently associated with obstructive sleep apnea. When both forms are present the condition is referred to as mixed sleep apnea (see SLEEP APNEA SYNDROMES). (Adams et al., Principles of Neurology, 6th ed, p395; Neurol Clin 1996;14(3):611-28)
Sleep Apnea Syndromes
Disorders characterized by multiple cessations of respirations during sleep that induce partial arousals and interfere with the maintenance of sleep. Sleep apnea syndromes are divided into central (see SLEEP APNEA, CENTRAL), obstructive (see SLEEP APNEA, OBSTRUCTIVE), and mixed central-obstructive types.
Sleep Apnea, Obstructive
A disorder characterized by recurrent apneas during sleep despite persistent respiratory efforts. It is due to upper airway obstruction. The respiratory pauses may induce HYPERCAPNIA or HYPOXIA. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. Frequent partial arousals occur throughout sleep, resulting in relative SLEEP DEPRIVATION and daytime tiredness. Associated conditions include OBESITY; ACROMEGALY; MYXEDEMA; micrognathia; MYOTONIC DYSTROPHY; adenotonsilar dystrophy; and NEUROMUSCULAR DISEASES. (From Adams et al., Principles of Neurology, 6th ed, p395)
Sleep Disorders, Intrinsic
Dyssomnias (i.e., insomnias or hypersomnias) associated with dysfunction of internal sleep mechanisms or secondary to a sleep-related medical disorder (e.g., sleep apnea, post-traumatic sleep disorders, etc.). (From Thorpy, Sleep Disorders Medicine, 1994, p187)
Obesity Hypoventilation Syndrome
HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.
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