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Published ahead of print on September 28, 2005, doi:10.1164/rccm.200504-637OC

Am. J. Respir. Crit. Care Med., Volume 172, Number 12, December 2005, 1590-1595

A more recent version of this article appeared on December 15, 2005
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Submitted on April 23, 2005
Accepted on September 26, 2005

Association of Sleep Apnea and Type II Diabetes: A Population-based Study

Kevin J Reichmuth1*, Diane Austin2, James B Skatrud1, and Terry Young2

1 Department of Medicine, University of Wisconsin Medical School, Madison, WI, USA, 2 Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA

* To whom correspondence should be addressed. E-mail: kj.reichmuth{at}hosp.wisc.edu.

Rationale: Cross-sectional association has been reported between sleep-disordered breathing (SDB) and insulin resistance, but no prospective studies have been performed to determine whether SDB is causal in the development of diabetes. Objectives: The purpose of our study was to investigate the prevalence and incidence of Type II diabetes in subjects with sleep disordered breathing and whether an independent relationship exists between them. Methods: A cross-sectional and longitudinal analysis was performed in 1,387 participants of the Wisconsin Sleep Cohort. Full polysomnography was used to characterize SDB. Diabetes was defined in two ways: 1) physician-diagnosis alone or 2) for those with glucose measurements, either fasting glucose ≥ 126 mg/dl or physician diagnosis. Measurements and Main Results: There was a greater prevalence of diabetes in subjects with increasing levels of sleep-disordered breathing. 14.7% of subjects with apnea-hypopnea index (AHI) ≥15 had a diagnosis of diabetes compared to 2.8% of subjects with AHI < 5. The odds ratio (OR) for having a physician-diagnoses of diabetes mellitus with an AHI ≥15 vs. < 5 was 2.30 (95% CI 1.28 - 4.11, p = 0.005) after adjustment for age, sex, and body habitus. The OR for developing DM within 4 years with AHI≥15 compared to AHI<5 was 1.62 (95% CI 0.67-3.65; p=0.24) when adjusting for age, sex, and body habitus. Conclusions: Diabetes is more prevalent in SDB and this relationship is independent of other risk factors. However, it is not clear that SDB is causal in the development of diabetes
Key words: sleep apnea, diabetes, prevalence, incidence




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