Type 2 Diabetes and Sleep Apnea: What Is the Connection?

Type 2 Diabetes and Sleep Apnea: What Is the Connection?

When we think about managing type 2 diabetes, factors such as diet, physical activity and blood glucose monitoring often come to mind. However, sleep health is another important consideration, particularly because research has identified a significant relationship between type 2 diabetes and obstructive sleep apnea (OSA).

Although these conditions affect different systems in the body, they frequently occur together and share several risk factors. Understanding this connection may help people living with type 2 diabetes recognise potential symptoms of sleep apnea and seek appropriate assessment when needed.

Understanding the relationship between diabetes and sleep apnea

Type 2 diabetes occurs when the body becomes resistant to insulin or cannot produce enough insulin to maintain blood glucose levels within a healthy range. Obstructive sleep apnea, on the other hand, is a sleep-related breathing disorder in which the upper airway repeatedly becomes partially or completely blocked during sleep, causing interruptions to normal breathing.

While the two conditions may initially seem unrelated, research has found that OSA is particularly common among people living with type 2 diabetes. According to the American Diabetes Association's Standards of Care in Diabetes—2026, the prevalence of OSA among people with type 2 diabetes may be as high as 23%, while the prevalence of sleep-disordered breathing more broadly may reach 58%.¹

These findings highlight why sleep health deserves consideration as part of overall diabetes care, especially when symptoms suggest that breathing may be disrupted during the night.

Why do these conditions frequently occur together?

One explanation for the relationship between type 2 diabetes and sleep apnea is that both conditions share several risk factors, including excess body weight and obesity.

Excess fatty tissue around the neck and upper airway can increase the likelihood of airway obstruction during sleep, while excess body fat, particularly around the abdomen, is also associated with insulin resistance and the development of type 2 diabetes.

However, shared risk factors are only part of the picture. Sleep apnea itself is characterised by repeated breathing interruptions, which can cause intermittent reductions in blood oxygen levels and frequent disruptions to normal sleep patterns.

Research suggests that these physiological disturbances may contribute to impaired glucose regulation and insulin resistance, although the relationship is complex and influenced by several factors.² Importantly, this does not mean that everyone with sleep apnea will develop diabetes, or that sleep apnea is necessarily responsible for poor blood glucose management in someone who already has the condition.

Can sleep apnea affect blood glucose regulation?

During an episode of obstructive sleep apnea, breathing becomes restricted or temporarily stops, prompting the body to respond to changes in oxygen levels and interrupted sleep.

Repeated episodes can activate the body's stress-response systems and contribute to physiological changes that may influence how effectively insulin works. Research has identified associations between OSA, intermittent hypoxia, sleep fragmentation and disturbances in glucose metabolism.²

However, an association between these conditions does not establish that sleep apnea directly causes diabetes, and the effects of treating OSA on long-term blood glucose control are not always consistent across studies.

For this reason, managing sleep apnea should be viewed as one component of overall health care rather than a replacement for established diabetes treatments, medications or lifestyle recommendations.

What symptoms should people with type 2 diabetes look out for?

Because sleep apnea occurs during sleep, many people may be unaware that their breathing is being interrupted throughout the night. In some cases, a partner or family member may be the first to notice unusual breathing patterns.

Common symptoms of obstructive sleep apnea 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, even when they believe they have spent enough time in bed.

The American Diabetes Association recommends evaluating people with diabetes for OSA when symptoms such as excessive daytime sleepiness, snoring or witnessed breathing pauses are present.¹ However, symptoms alone cannot confirm a diagnosis, and further assessment may be necessary to determine whether sleep apnea is contributing to disrupted sleep.

Why recognising sleep apnea matters

For someone already managing type 2 diabetes, identifying an additional health condition can feel overwhelming, particularly when diabetes care already involves ongoing monitoring and lifestyle considerations.

However, recognising sleep apnea may provide an opportunity to address previously unexplained sleep difficulties and improve overall wellbeing.

The American Diabetes Association recognises several treatment options for obstructive sleep apnea, including CPAP therapy, oral appliances and lifestyle modifications, depending on individual clinical needs. While appropriate treatment may help manage sleep apnea symptoms and improve sleep-related outcomes, it should not be considered a treatment or cure for type 2 diabetes.¹

Although treating sleep apnea should not be expected to resolve diabetes or automatically improve blood glucose levels, appropriate management may help address disrupted breathing during sleep and support broader health outcomes.

How Sove CPAP Clinic Can Help

If you're living with type 2 diabetes and regularly experience snoring, breathing interruptions, excessive daytime sleepiness or unrefreshing sleep, it may be worth speaking with your doctor about whether obstructive sleep apnea could be contributing to your symptoms.

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.

With over 100 clinics nationwide, Sove offers bulk-billed home sleep studies along with personalised support for those diagnosed with obstructive sleep apnea. Depending on your individual needs and clinical assessment, treatment options may include CPAP therapy or mandibular advancement splints (MAS).

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. MAS is intended to assist in and or prevent snoring and/or obstructive sleep apnea. When considering whether a sleep study, MAS or CPAP is right for you, speak to your doctor. Medicare criteria and T&Cs apply.

References

American Diabetes Association Professional Practice Committee. “4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2026.” Diabetes Care, 2026. https://doi.org/10.2337/dc26-S004

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