Sleeping with Type 1 diabetes: OSA and other sleep issues linked
A couple weeks ago we discussed how sugar/glucose levels can affect your sleeping and how they correlate with sleep disorders and overall tiredness. Sleep can affect your blood sugar levels, and your blood glucose control can also affect your sleep. It’s a vicious cycle.
High blood sugar levels make it less comfortable for you to sleep by feelings of warmness, irritability and unsettledness. Low Blood sugar levels cause a variety of problems within your central nervous system which can include nightmares, confusion, sleepwalking and restlessness.
In our Educational Series for National Diabetes Month we are going to briefly discuss the relationship between Type 1 diabetes, OSA, and other common sleep disturbances.
Diabetes Types
| Type 1 diabetes | Type 2 diabetes |
| Symptoms usually start in childhood or young adulthood. People often seek medical help, because they are seriously ill from sudden symptoms of high blood sugar. | The person may not have symptoms before diagnosis. Usually the disease is discovered in adulthood, but an increasing number of children are being diagnosed with the disease. Those who are obese or have a higher BMI are more at risk. |
| Episodes of low blood sugar level (hypoglycemia) are common. | There are no episodes of low blood sugar level, unless the person is taking insulin or certain diabetes medicines. |
| It cannot be prevented. | It can be prevented or delayed with a healthy lifestyle, including maintaining a healthy weight, eating sensibly, and exercising regularly. |
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common form of sleep apnea. Apnea literally translates as “cessation of breathing” which means that during sleep your breathing stops periodically during the night for a few seconds. These lapses in breathing can occur for up to ten seconds or more and can happen up to hundreds of times a night in severe cases.
OSA is caused by blockage of the upper respiratory airways in which either the throat muscles collapse, the tongue falls back into the airway, or enlarged tonsils and/or adenoids impede air flow. When your airway becomes cutoff, the brain has to wake itself to signal the respiratory system to kick back into gear. This often leads to breathing resuming with loud gasps, snorts, or body jerks that may wake you from your slumber and disrupt your sleep.
There are three different levels of OSA based on the number of nightly sleep interruptions.
- Mild OSA– The sufferer experiences 5-14 episodes of interruptions in breathing in an hour.
- Moderate OSA-The sufferer experiences 15-30 episodes of interruptions in breathing in an hour.
- Severe OSA-The sufferer experiences 30 or more interruptions in breathing in an hour.
Type 1 Diabetes and Sleep Apnea
There are copious amounts of scientific data showcasing the correlation with Type 2 Diabetes/Obesity and OSA. But, what about the presence of OSA in non-obese or Type 1 diabetics? Is there a link and are they related?
While there is not as much information regarding Type 1 diabetes and OSA, the data and research currently available suggests the prevalence of sleep apnea syndrome is high in Type 1 diabetics.
Researchers found OSA in 39 of 90 adults with Type 1 diabetes. The majority of those tested were of normal weight/BMI. The OSA statistics were also found to be the highest in those who have been affected by Type I Diabetes the longest.
Those with OSA were more likely to have diabetes-related eye and kidney complications and to experience low blood glucose during sleep.
Type 1 Diabetes and Sleep Disturbances
That being said, let’s dive further into what we know regarding sleep related issues affecting those with Type 1 diabetes:
- Type 1 diabetic patients have more sleep apneas than control patients.
- Patients with poorly controlled diabetes have more apneas than patients with well-controlled diabetes.
- Respiratory events during sleep correlated significantly with glycemic control and with the duration of diabetes.
- Respiratory control is compromised very early in children with diabetes.
- 1/3rd of Type 1 diabetes patients tested have difficulty getting to sleep and/or have sleep apnea.
- Type 1 Diabetics suffer from the same complications of sleep apnea as Type 2 diabetics; they get fatigue and depression from lack of deep sleep and hard to control blood sugars.
- Type 1 Diabetics with changing glucose levels during sleep cause reoccurring awakenings during sleep.
Also, various aspects of diabetes could be linked to increased prevalence of sleep disturbances. Optimizing sleep duration and sleep quality can be considered as a potential therapeutic target to improve glucoregulation in patients with Type 1 diabetes.
The good news is that diabetes and OSA-related predictors may allow for early preventive intervention for patients.
The first step is to address any sleep disturbances with a doctor. Talk to your primary care doctor if you feel that your Type 1 diabetes is affecting your sleep. If you have a child with Type 1 diabetes who has sleeping issues consult their pediatrician. Your doctor may suggest a conducting a sleep study to further identify additional sleep issues you may be having. At the Alaska Sleep Clinic we specialize not only in treating adult patients with their sleeping disorders, but children as well. For a free phone consultation click the link below.
