Can Sleep Apnea Make Blood Sugar Harder to Manage?

Can Sleep Apnea Make Blood Sugar Harder to Manage?

Managing blood sugar levels involves more than simply paying attention to what you eat. Physical activity, medication, stress and sleep can all play a role in glucose regulation, which is why researchers have become increasingly interested in the relationship between sleep disorders and metabolic health.

One condition receiving particular attention is obstructive sleep apnea (OSA), a sleep-related breathing disorder characterised by repeated interruptions to breathing throughout the night. Research has identified associations between OSA, insulin resistance and difficulties with glucose regulation, although these relationships are complex and do not necessarily mean that sleep apnea directly causes poor blood sugar control.

How does the body regulate blood sugar?

After eating, carbohydrates are broken down into glucose, which enters the bloodstream and provides an important source of energy for the body's cells. In response, the pancreas releases insulin, a hormone that helps glucose move from the bloodstream into cells where it can be used or stored.

In people with type 2 diabetes, the body becomes less responsive to insulin, a process known as insulin resistance, and may eventually struggle to produce enough insulin to maintain blood glucose levels within the recommended range.

While factors such as nutrition, physical activity and medication are central to diabetes management, research suggests that sleep health may also be relevant, particularly when normal sleep patterns are repeatedly disrupted.¹

What happens to the body during sleep apnea?

Obstructive sleep apnea occurs when the muscles and tissues surrounding the upper airway relax during sleep, allowing the airway to become partially or completely obstructed. These episodes can temporarily reduce oxygen levels and trigger brief awakenings as the body works to restore normal breathing.

Although these awakenings may be too brief to remember, repeated episodes can disrupt normal sleep patterns and contribute to fragmented sleep.

Researchers have identified two characteristics of OSA that may be particularly relevant to metabolic health: intermittent hypoxia, which refers to repeated reductions in blood oxygen levels, and sleep fragmentation, which involves frequent interruptions to normal sleep.

Both have been associated with changes in the body's physiological stress responses and glucose metabolism, although the extent to which they independently influence blood sugar regulation remains an area of ongoing research.²

The relationship between sleep apnea and insulin resistance

Insulin resistance occurs when the body's cells become less responsive to insulin, making it more difficult for glucose to move efficiently from the bloodstream into tissues.

Research has identified an association between obstructive sleep apnea and insulin resistance, with several potential biological mechanisms proposed to explain this relationship. These include changes in sympathetic nervous system activity, inflammatory processes and the body's response to intermittent reductions in oxygen levels.²

However, interpreting these findings requires caution because OSA and type 2 diabetes share several risk factors, including excess body weight and obesity, which can independently influence insulin sensitivity.

As a result, while research suggests that sleep-disordered breathing may be associated with impaired glucose regulation, it cannot be assumed that sleep apnea is the direct cause of insulin resistance or elevated blood glucose levels in an individual.

Does poor sleep make diabetes management more difficult?

Sleep health is increasingly recognised as an important consideration in diabetes care, particularly because insufficient or disrupted sleep has been associated with changes in glucose metabolism and insulin sensitivity.¹

For people living with type 2 diabetes, this means that ongoing sleep difficulties may be worth discussing with their healthcare professional, especially when symptoms suggest an underlying sleep disorder.

However, blood glucose levels are influenced by numerous factors, including medications, dietary intake, physical activity, illness and individual metabolic differences. It would therefore be misleading to attribute changes in blood sugar levels to sleep apnea without an appropriate medical assessment.

Similarly, although CPAP therapy is an established treatment for obstructive sleep apnea, research examining its effects on blood glucose regulation has produced mixed findings. CPAP should not be considered a treatment for diabetes, and people using it should continue following the diabetes management plan recommended by their treating healthcare professional.

Recognising when sleep apnea may be worth investigating

Because obstructive sleep apnea occurs during sleep, people may not realise that their breathing is being interrupted, particularly if they sleep alone or do not remember waking during the night.

Common symptoms can include loud or persistent snoring, witnessed pauses in breathing, gasping or choking during sleep, morning headaches and excessive daytime sleepiness. Some people may also experience difficulty concentrating or regularly wake feeling unrefreshed, despite spending what appears to be an adequate amount of time in bed.

For someone managing type 2 diabetes, these symptoms may be worth raising with their doctor, particularly if they occur frequently or begin affecting daily activities.

A sleep study may be recommended where clinically appropriate to investigate whether obstructive sleep apnea is present, although symptoms alone cannot confirm a diagnosis.

How Sove CPAP Clinic Can Help

If you are living with type 2 diabetes and experiencing ongoing snoring, unrefreshing sleep or excessive daytime tiredness, speaking with your doctor about your sleep health may help identify whether further assessment is appropriate.

At Sove CPAP Clinic, our team of Sleep and Respiratory Physicians and experienced Treatment Consultants can help investigate potential sleep-disordered breathing and guide you towards an appropriate assessment and treatment pathway.

To learn more about our sleep services or arrange an assessment, call our friendly team on 1300 76 29 39 or email info@thecpapclinic.com.au.

ALWAYS FOLLOW THE DIRECTIONS FOR USE. CPAP is used for Obstructive Sleep Apnea treatment. When considering whether a sleep study or CPAP is right for you, speak to your doctor. Medicare criteria and T&Cs apply.

References

Reutrakul, S., & Van Cauter, E. “Sleep Influences on Obesity, Insulin Resistance, and Risk of Type 2 Diabetes.” Metabolism, vol. 67, 2017, pp. 47–56. https://doi.org/10.1016/j.metabol.2016.10.009

Drager, L. F., Togeiro, S. M., Polotsky, V. Y., & Lorenzi-Filho, G. “Obstructive Sleep Apnea: A Cardiometabolic Risk in Obesity and the Metabolic Syndrome.” Journal of the American College of Cardiology, vol. 62, no. 7, 2013, pp. 569–576. https://doi.org/10.1016/j.jacc.2013.05.045