Obstructive Sleep Apnea and Type 1 Diabetes

May 11,2022 |
Man using his CPAP machine.

Sleeping disorders are a range of conditions that cause a disruption to your normal sleeping patterns. Characteristics can range from difficulty falling asleep and staying asleep to increased movement throughout the night and irregular breathing. While some people may experience periodic bouts of restlessness or problems with sleep schedules, chronic issues can have serious negative health effects. If you have an underlying condition, like type 1 diabetes, these effects become even more pronounced and may lead to further complications. Since one of the most common types of sleeping disorders amongst aging individuals is obstructive sleep apnea, it's important to understand the signs and seek help. This is especially true for individuals who have obstructive sleep apnea and type 1 diabetes. Here, we’ll explore the link between the two and the importance of seeking professional treatment.


What is Type 1 Diabetes?

Type­­­ 1 diabetes is an autoimmune condition that affects the cells in your pancreas. During the onset of this condition, your body begins to attack the healthy, beta cells in the pancreas. These are the cells that are responsible for making the hormone insulin, which helps turn sugar into cellular energy. Type 1 diabetes only makes up about 5% to 10% of all cases of diabetes and the cause is relatively unknown. While it can cause frustration or emotional turmoil when you or a loved one is diagnosed with type 1 diabetes, there are ways to manage the disease and live a long, healthy life.


Important Sleep Apnea Information

Sleep apnea is a type of sleeping disorder that affects over 100 million people across the world. It causes individuals to periodically stop breathing throughout the night, either from an obstruction or failures in communication between the brain and muscles that control breathing. Obstructive sleep apnea is far more common than central sleep apnea and can be caused by a variety of factors.

Obstructed sleep apnea occurs when the muscles in your throat become relaxed and block the passageway of air. This causes individuals to repeatedly stop and start breathing throughout the night. When the muscles in the back of your throat relax to a certain degree, the airway becomes blocked and carbon dioxide begins to build up. This triggers your brain to wake up the body, thus reopening the airways. When an individual with obstructive sleep apnea is woken up to breathe, they don’t remember the occurrence. Instead, it’s usually their partner who suffers, as rousing from sleep is often accompanied by a body jerk, loud snore, or even a gasp which can be startling. Obstructive sleep apnea also reduces the flow of oxygen to your body and can lead to problems with your heart and other complications.

Risk Factors for Sleep Apnea

While anyone can develop obstructive sleep apnea, there are a few factors that increase your risk. The biggest and most preventable risk factor is excess weight. When fat begins to accumulate around the upper airway, it puts strain on breathing—especially when laying down. This can cause airways to close and spark the onset of obstructive sleep apnea. Losing weight can help reduce this risk factor.

Other risk factors include older age, a naturally narrow airway, high blood pressure, chronic nasal congestion, family history, smoking, asthma, and gender. Men are two to three times more likely to experience obstructive sleep apnea. Another risk factor that’s recently been uncovered is a type 1 diabetes diagnosis.


Sleep Apnea and Type 1 Diabetes: How Are They Connected?

In the past, there was plenty of research published regarding the connection between type 2 diabetes and sleep apnea, but the relationship with type 1 diabetes was left unexplored. Recent studies have found that obstructive sleep apnea, however, is also high in individuals living with type 1 diabetes. In fact, some studies have found obstructive sleep apnea in as many as 30% of adults living with type 1 diabetes. To better understand this relationship, consider some of the following ways in which sleep apnea and type 1 diabetes are connected.

Sleep Apnea’s Effect on Blood Sugar

Sleep deprivation can have a direct impact on cellular sensitivity to insulin, which causes disruptions to your blood sugar levels. When blood sugar levels are high, the kidneys work to overcompensate the imbalance by producing more urine. This can lead to restless sleep and bouts of nocturia that keep you away during the night. When your blood sugar levels are low (nocturnal hypoglycemia), you may experience restless sleep, nightmares, night sweats, and more. This creates an endless cycle of fluctuating blood sugar levels that can be hard on your body, especially when you’re living with type 1 diabetes. Conversely, the symptoms associated with type 1 diabetes may lead to problems with sleeping schedules. Having obstructive sleep apnea can also increase your risk of developing diabetes as you age. While this is often linked to type 2 diabetes, the implications are far reaching.

Insulin Resistance and Sleeping Disorders

When you sleep, your body doesn’t need to put effort into reacting to external stimuli. Instead, all of its energy is focused on internal processes and neural conversions. This reduces your heart rate and blood pressure while increasing hormone regulation in preparation for the following day. Since insulin is a hormone, sleep disruptions can create problems with insulin resistance or production. Sleep deprivation decreases your body’s ability to transport glucose from your bloodstream into your cells, thus raising your blood sugar levels and causing problems with diabetes management. You should take a proactive measure to do whatever you can to ensure you’re receiving an adequate amount of REM sleep each night, which can help you reduce any further issues with processing insulin.

Why is Sleep Important When Managing Type 1 Diabetes

Sleep apnea in individuals with type 1 diabetes is based on abnormal glycemia and microvascular complications. It is not associated with a higher body max index (BMI) for individuals with type 1 diabetes, although those with type 2 diabetes and sleep apnea do tend to have higher BMIs. However, since type 1 diabetes tends to be diagnosed during childhood, the effects of unstable blood glucose levels and impaired sleep can increase the risk of retinopathy and other diabetes complications. This is why it's important to prioritize your sleep when you manage your diabetes.

As mentioned, poor sleep contributes to a decrease in glycemic control, which in turn increases your risk of diabetes-related complications. The increase in carbon dioxide that occurs when your breathing stops puts added stress on your heart, which can increase your risk of heart disease or stroke. It can also impact your body’s hunger hormones, which makes it more difficult to control your appetite and make healthy decisions in regard to food. Individuals who are sleep deprived tend to consume an extra 385 calories per day compared with those who got a good night’s sleep. This can lead to weight gain, which further complicates diabetes management.

When it comes to managing type 1 diabetes, getting adequate amounts of good quality sleep each night is just as important as eating healthy, monitoring your blood sugar levels, and exercising regularly.

When to Seek Medical Help

Sleep apnea can also contribute to a number of long-term complications in individuals living with type 1 diabetes. Obstructive sleep apnea, for example, is independently associated with macrovascular complications and retinopathy. Macrovascular complications are complications that occur due to disease of the large blood vessels. These may include coronary heart disease, cardiomyopathy, arrhythmias, and even sudden death. Since type 1 diabetes is also linked to heart disease and stroke, properly treating your sleep apnea is essential to your ongoing health.

If you’re living with type 1 diabetes, talk to your doctor about undergoing screening for sleep apnea. Symptoms are usually quite noticeable to partners who share your bed, so don’t ignore them if they complain about snoring or startling noises during the night. If you’re constantly feeling fatigued during the day, receiving complaints from your partner, or just aren’t feeling like yourself lately, see your doctor as soon as possible. Undergoing a sleep analysis can help you address sleep apnea and reduce your risk of serious complications in the future.


About Byram Healthcare and Apria

Since 1968, Byram Healthcare has been helping to improve health outcomes and affordability of care for people managing their chronic conditions at homeFor those living with type 2 diabetes, we have a range of continuous blood glucose monitors. We also offer diabetes support and educational materials to give you everything you need for comprehensive care. If you’ve been diagnosed with sleep apnea, Apria offers a comprehensive range of products and services for respiratory therapy and obstructive sleep apnea treatment. Apria is part of the Byram Healthcare family.