Prevalence of Sleep Apnea in a Population of Adults with Type 2 Diabetes Mellitus
Abstract
Objective To assess the prevalence of sleep apnea (SA) in adults with type 2 diabetes mellitus (T2DM) and examine whether demographics and comorbid factors were associated with SA in this population.Methods This study enrolled 330 consecutive adults with T2DM referred to a diabetes clinic, 279 of whom completed the study. Evaluation of the presence of SA was performed with use of a single-channel recording device that measures disordered breathing events from a nasal cannula airflow signal. The device was worn by the study participants in their home, after instruction in appropriate use by clinical staff at the diabetes center. The presence and severity of SA were determined by use of an apnea-hypopnea index (AHI), reflecting periods of diminished and absent breathing. Demographic and medical information data were collected to detect factors associated with SA in this study population. In addition, a time and cost analysis was conducted regarding the screening process for SA by clinical staff at the diabetes center.Results The results show a high prevalence of SA in adults with T2DM, ranging from 48% (AHI level of >or=10 events/h) to 29% (AHI level of >or=20 events/h). At an AHI cutoff value of >or=15 events/h, the overall prevalence rate was 36% (49% in male and 21% in female participants). The following variables were associated with SA: age >or=62 years, male sex, body mass index >or=30 kg/m2, snoring, and reports of stopping breathing during sleep. The time and cost analysis showed that the screening device involved minimal setup time, was simple to use, and was a cost-effective method to screen for SA.Conclusion SA is a common disorder associated with major morbid conditions, including hypertension, obesity, cardiovascular disease, and insulin resistance. Predisposing factors for SA and T2DM are similar. This study showed that SA has a high prevalence in adults with T2DM and identified factors that may be associated with its presence in this population. Assessment for SA can be easily performed in an outpatient setting with a portable recording device such as the one used in this study. Screening for SA should be considered in the T2DM population.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In patients with type 2 diabetes, the prevalence of obstructive sleep apnea assessed by full-night polysomnography ranges from 58% to 86%.
“In patients with type 2 diabetes, the prevalence of OSA assessed with full night polysomnography, i.e., the gold standard method for the diagnosis of OSA, ranged from 58% to 86% [2, 45, 52, 134].”
From Sleep and metabolic function (2012) · cites this paper as [45]
Cites
The International Classification of Sleep Disorders
Daroff, R. B. (1991) · Neurology · doi:10.1212/wnl.41.1.160 · Cited by 5,025 · see citing works
Prospective Study of the Association between Sleep-Disordered Breathing and Hypertension
Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005113421901 · Cited by 4,973 · see citing works
Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective
Young, T., Peppard, P. E., & Gottlieb, D. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2109080 · Cited by 4,244 · see citing works
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,668 · see citing works
Sullivan, C., Berthon-Jones, M., Issa, F., & Eves, L. (1981) · The Lancet · doi:10.1016/s0140-6736(81)92140-1 · Cited by 2,731 · see citing works
Harris, M. I., Flegal, K. M., Cowie, C. C., Eberhardt, M. S., Goldstein, D. E., Little, R. R., Wiedmeyer, H.-M., & Byrd-Holt, D. D. (1998) · Diabetes Care · doi:10.2337/diacare.21.4.518 · Cited by 2,703 · see citing works
The International Classification of Sleep Disorders: Diagnostic and Coding Manual
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-5-413_1 · Cited by 2,416 · see citing works
The Sleep Heart Health Study: Design, Rationale, and Methods
(1997) · Sleep · doi:10.1093/sleep/20.12.1077 · Cited by 1,331 · see citing works
Young, T. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.8.893 · Cited by 1,304 · see citing works
Obstructive Sleep Apnea Is Independently Associated with Insulin Resistance
Ip, M. S. M., Lam, B., Ng, M. M. T., Lam, W. K., Tsang, K. W. T., & Lam, K. S. L. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.5.2103001 · Cited by 1,300 · see citing works
Vgontzas, A. N., Papanicolaou, D. A., Bixler, E. O., Hopper, K. D., Lotsikas, A. J., LIN, H., Kales, A., & Chrousos, G. P. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.3.6484 · Cited by 1,196 · see citing works
Punjabi, N. M. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh261 · Cited by 1,107 · see citing works
Sleep-disordered Breathing and Insulin Resistance in Middle-aged and Overweight Men
Punjabi, N. M., Sorkin, J. D., Katzel, L. I., Goldberg, A. P., Schwartz, A. R., & SMITH, P. L. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.5.2104087 · Cited by 955 · see citing works
Becker, H. F., Jerrentrup, A., Ploch, T., Grote, L., Penzel, T., Sullivan, C. E., & Peter, J. H. (2003) · Circulation · doi:10.1161/01.cir.0000042706.47107.7a · Cited by 931 · see citing works
Sleep duration as a risk factor for the development of type 2 diabetes
Yaggi, H. K., Araujo, A. B., & McKinlay, J. B. (2006) · Diabetes Care · doi:10.2337/diacare.29.03.06.dc05-0879 · Cited by 790 · see citing works
Association of Sleep Apnea and Type II Diabetes
Reichmuth, K. J., Austin, D., Skatrud, J. B., & Young, T. B. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200504-637oc · Cited by 770 · see citing works
Harsch, I. A., Schahin, S. P., Radespiel-Tröger, M., Weintz, O., Jahreiß, H., Fuchs, F. S., Wiest, G. H., Hahn, E. G., Lohmann, T., Konturek, P. C., et al. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200302-206oc · Cited by 583 · see citing works
Relation of Sleepiness to Respiratory Disturbance Index: The Sleep Heart Health Study
Gottlieb, D. J., Whitney, C. W., BONEKAT, W. H., Iber, C., James, G. D., Lebowitz, M. D., Nieto, F. J., & Rosenberg, C. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.2.9804051 · Cited by 571 · see citing works
Baldwin, C. M., Griffith, K. A., Nieto, F. J., O’Connor, G. T., Walsleben, J. A., & Redline, S. S. (2001) · SLEEP · doi:10.1093/sleep/24.1.96 · Cited by 556 · see citing works
Diabetes and Sleep Disturbances
Resnick, H. E., Redline, S., Shahar, E., Gilpin, A., Newman, A., Walter, R., Ewy, G. A., Howard, B. V., & Punjabi, N. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.702 · Cited by 504 · see citing works
Davies, R. J. O., Ali, N. J., & Stradling, J. R. (1992) · Thorax · doi:10.1136/thx.47.2.101 · Cited by 480 · see citing works
Babu, A. R., Herdegen, J., Fogelfeld, L., Shott, S., & Mazzone, T. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.4.447 · Cited by 453 · see citing works
Snoring and sleep apnoea in men: association with central obesity and hypertension.
Grunstein, R. R., Wilcox, I., Yang, T. S., Gould, Y., & Hedner, J. A. (1993) · PubMed · Cited by 331 · see citing works
Snoring as a Risk Factor for Type II Diabetes Mellitus: A Prospective Study
Al‐Delaimy, W. K., Manson, J. E., Willett, W. C., Stampfer, M. J., & Hu, F. B. (2002) · American Journal of Epidemiology · doi:10.1093/aje/155.5.387 · Cited by 328 · see citing works
Erman, M. K., Stewart, D. A., EINHORN, D. F., Gordon, N. D., & Casal, E. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26861 · Cited by 326 · see citing works
Self-citationImpaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome
Meslier, N., Gagnadoux, F., Giraud, P., Person, C., Ouksel, H., Urban, T., & Racineux, J.-L. (2003) · European Respiratory Journal · doi:10.1183/09031936.03.00089902 · Cited by 301 · see citing works
Brooks, B. (1994) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.79.6.1681 · Cited by 295 · see citing works
Sleep‐disordered breathing and glucose metabolism in hypertensive men: a population‐based study
Elmasry, A., Lindberg, E., Berne, C., Janson, C., Gíslason, Þ., Tageldin, M. A., & Boman, G. (2001) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2001.00787.x · Cited by 286 · see citing works
Sleep-disordered breathing, glucose intolerance, and insulin resistance
Punjabi, N. M., Ahmed, M. M., Polotsky, V. Y., Beamer, B. A., & O'Donnell, C. P. (2003) · Respiratory Physiology & Neurobiology · doi:10.1016/s1569-9048(03)00079-x · Cited by 228 · see citing works
Harsch, I. A., Schahin, S. P., Brückner, K., Radespiel-Tröger, M., Fuchs, F. S., Hahn, E. G., Konturek, P. C., Lohmann, T., & Ficker, J. H. (2004) · Respiration · doi:10.1159/000077423 · Cited by 219 · see citing works
Elmasry, A., Janson, C., Lindberg, E., Gíslason, Þ., Tageldin, M. A., & Boman, G. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00683.x · Cited by 196 · see citing works
Employer Costs for Employee Compensation, 1986-99
Herman, A. M., & Abraham, K. G. (2000) · Cited by 95 · see citing works
High incidence of sleep apnea syndrome in a male diabetic population
Katsumata, K., Okada, T., Miyao, M., & Katsumata, Y. (1991) · Diabetes Research and Clinical Practice · doi:10.1016/0168-8227(91)90032-9 · Cited by 74 · see citing works
Validierung von microMESAM® als Screeningsystem für schlafbezogene Atmungsstörungen
Wang, Y., Teschler, T., Weinreich, G., Hess, S., Wessendorf, T., & Teschler, H. (2003) · Pneumologie · doi:10.1055/s-2003-812423 · Cited by 70 · see citing works
Insulin Resistance and Obstructive Sleep Apnea: Is Increased Sympathetic Stimulation the Link?
Chasens, E. R., Weaver, T. E., & Umlauf, M. G. (2003) · Biological Research For Nursing · doi:10.1177/1099800403257088 · Cited by 32 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Effects of poor and short sleep on glucose metabolism and obesity risk
Spiegel, K., Tasali, E., Leproult, R., & Van Cauter, E. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.23 · Cited by 857 · see citing works
Obstructive Sleep Apnea and Diabetes
Reutrakul, S., & Mokhlesi, B. (2017) · Chest · doi:10.1016/j.chest.2017.05.009 · Cited by 667 · see citing works
Anothaisintawee, T., Reutrakul, S., Van Cauter, E., & Thakkinstian, A. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.10.002 · Cited by 640 · see citing works
Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes
Foster, G. D., Sanders, M. H., Millman, R., Zammit, G., Borradaile, K. E., Newman, A. B., Wadden, T. A., Kelley, D., Wing, R. R., Pi Sunyer, F. X., et al. (2009) · Diabetes Care · doi:10.2337/dc08-1776 · Cited by 600 · see citing works
Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes
Aronsohn, R. S., Whitmore, H., Van Cauter, E., & Tasali, E. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200909-1423oc · Cited by 453 · see citing works
Obstructive Sleep Apnea and Metabolic Syndrome: Alterations in Glucose Metabolism and Inflammation
Tasali, E., & Ip, M. S. M. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200708-139mg · Cited by 365 · see citing works
Reutrakul, S., & Van Cauter, E. (2014) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12355 · Cited by 321 · see citing works
Obstructive sleep apnoea and type 2 diabetes mellitus: a bidirectional association
Aurora, R. N., & Punjabi, N. M. (2013) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(13)70039-0 · Cited by 273 · see citing works
Obstructive Sleep Apnea and Type 2 Diabetes: Is There a Link?
Pamidi, S., & Tasali, E. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00126 · Cited by 231 · see citing works
Martínez-Cerón, E., Barquiel, B., Bezos, A.-M., Casitas, R., Galera, R., García-Benito, C., Hernanz, A., Alonso-Fernández, A., & Garcia-Rio, F. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201510-1942oc · Cited by 214 · see citing works
Morselli, L. L., Guyon, A., & Spiegel, K. (2012) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-011-1053-z · Cited by 199 · see citing works
“, the gold standard method for the diagnosis of OSA, ranged from 58% to 86% [2, 45, 52, 134].”
Liu, L., Su, G., Wang, S., & Zhu, B. (2019) · Sleep and Breathing · doi:10.1007/s11325-018-1714-7 · Cited by 124 · see citing works
Reduced Sleep Duration or Quality: Relationships With Insulin Resistance and Type 2 Diabetes
Tasali, E., Leproult, R., & Spiegel, K. (2009) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2008.10.002 · Cited by 129 · see citing works
Obstructive sleep apnea: role in the risk and severity of diabetes
Pamidi, S., Aronsohn, R. S., & Tasali, E. (2010) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2010.08.009 · Cited by 121 · see citing works
Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity
Garcia, J. M., Sharafkhaneh, H., Hirshkowitz, M., Elkhatib, R., & Sharafkhaneh, A. (2011) · Respiratory Research · doi:10.1186/1465-9921-12-80 · Cited by 75 · see citing works
Fallahi, A., Jamil, D. I., Karimi, E. B., Baghi, V., & Gheshlagh, R. G. (2019) · Diabetes & Metabolic Syndrome: Clinical Research & Reviews · doi:10.1016/j.dsx.2019.06.030 · Cited by 71 · see citing works
Aiding sleep in type 2 diabetes: therapeutic considerations
Tan, X., van Egmond, L., Chapman, C. D., Cedernaes, J., & Benedict, C. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30233-4 · Cited by 72 · see citing works
Shechter, A., Foster, G. D., Lang, W., Reboussin, D. M., St‐Onge, M., Zammit, G., Newman, A. B., Millman, R. P., Wadden, T. A., Jakicic, J. M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12559 · Cited by 30 · see citing works
Smyth, A., Jenkins, M., Dunham, M., Kutzer, Y., Taheri, S., & Whitehead, L. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108532 · Cited by 28 · see citing works
- Authors
- Einhorn, D., Stewart, D. A., Erman, M. K., Gordon, N., Philis-Tsimikas, A., & Casal, E.
- Affiliations
- University of California San Diego (US)
- ResMed (United States) (US)
- Corresponding author
- Einhorn, Daniel
- ORCID
- Einhorn, Daniel
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 13
- Issue
- 4
- Pages
- 355-362
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2151012450
- Cited by
- 232
- References
- 35
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 6 · 2022: 12 · 2021: 15 · 2020: 10 · 2019: 11 · 2018: 17 · 2017: 18 · 2016: 23 · 2015: 17 · 2014: 19 · 2013: 9 · 2012: 18
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Funders
- ResMed
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- sleep apnea, type 2 diabetes, prevalence, apnea-hypopnea index, home sleep monitoring, risk factors, obesity, snoring, sex differences, diabetes screening, cost-effectiveness
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Female, Humans, Male, Mass Screening, Middle Aged, Outpatients, Risk Factors, Salaries and Fringe Benefits, Sleep Apnea Syndromes, Transducers, Comorbidity, Prevalence, Health Care Costs, Time Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
