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4 . 2022

Timely diagnosis and correction of obstructive sleep apnea and sleep and wake rhythm disorders in the management of cardiometabolic health in patients with type 2 diabetes mellitus

Abstract

Sleep disorders, including obstructive sleep apnea, are common in type 2 diabetes, but in most patients this problem is not given due attention due to the lack of information in the Russian clinical guidelines “Type 2 diabetes in adults” and, thus, low awareness of endocrinologists about the importance of early detection and correction. This article shows the necessity of timely diagnosis of sleep disorders in outpatient endocrinological practice and improvement of carbohydrate, lipid metabolism, blood pressure and quality of life against the background of РAР therapy and normalization of the rhythm of sleep and wakefulness in a patient with type 2 diabetes mellitus using a clinical example.

Keywords:sleep disorders; obstructive sleep apnea; diabetes mellitus; computed tomography; PAP therapy

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Pyanykh O.P., Lebedeva D.D. Timely diagnosis and correction of obstructive sleep apnea and sleep and wake rhythm disorders in the management of cardiometabolic health in patients with type 2 diabetes mellitus. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (4): 107–115. DOI: https://doi.org/10.33029/2304-9529-2022-11-4-107-115 (in Russian)

References

1. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes – 2022. Diabetes Care. 2022; 45 (Suppl. 1): S 46–59. DOI: https://doi.org/10.2337/dc22-S004

2. Sateia M.J. International classification of sleep disorders-third edition highlights and modifications. Chest. 2014; 146 (5): 1387–94. DOI: https://doi.org/10.1378/chest.14-0970

3. IDF. Diabetes prevalence. In: International Diabetes Federation Atlas. 10th ed. 2021: 34–77.

4. Punjabi N.M., Sorkin J.D., Katzel L.I., Goldberg A.P., et al. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med. 2002; 2002 (165): 677–82. DOI: https://doi.org/10.1164/ajrccm.165.5.2104087

5. Huang T., Lin B.M., Stampfer M.J., Tworoger S.S., et al. A population-based study of the bidirectional association between obstructive sleep apnea and type 2 diabetes in three prospective U.S. Cohorts. Diabetes Care. 2018; 41 (10): 2111–9. DOI: https://doi.org/10.2337/dc18-0675

6. Malik J.A., Masoodi S.R., Shoib S. Obstructive sleep apnea in type 2 diabetes and impact of continuous positive airway pressure therapy on glycemic control. Indian J Endocrinol Metab. 2017; 21 (1): 106–12. DOI: https://doi.org/10.4103/2230-8210.196005

7. Sharma S.K., Katoch V.M., Mohan A., Kadhiravan T., et al. Consensus & evidence-based INOSA guidelines 2014. Indian J Chest Dis Allied Sci. 2015; 57 (1): 48–64. DOI: https://doi.org/10.5005/ijcdas-57-1-48

8. Butt A.M., Syed U., Arshad A. Predictive value of clinical and questionnaire based screening tools of obstructive sleep apnea in patients with type 2 diabetes mellitus. Cureus. 2021; 13 (9): e18009. doi: https://doi.org/10.7759/cureus.18009

9. Kapur V.K., Auckley D.H., Chowdhuri S., Kuhlmann D.C., et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017; 13 (3): 479–504. DOI: https://doi.org/10.5664/jcsm.6506

10. Malhotra A., Ayapp I., Ayas N., et al. Metrics of sleep apnea severity: beyond the apnea-hypopnea index. Sleep. 2021; 44 (7): zsab030. DOI: https://doi.org/10.1093/sleep/zsab030

11. Ioachimescu O.C., Allam J.S., Samarghandi A., Anand N., et al. Performance of peripheral arterial tonometry-based testing for the diagnosis of obstructive sleep apnea in a large sleep clinic cohort. J Clin Sleep Med. 2020; 16 (10): 1663–74. DOI: https://doi.org/10.5664/jcsm.8620

12. Gorbunova M.V. Clinical and pathogenetic characteristics of metabolic disorders and substantiation of ventilation support methods in the complex therapy of patients with obstructive sleep apnea^ Abstract of Diss. Moscow, 2022. (in Russian)

13. Litovets T.S., Krasnozhen V.N. Quantification of the loudness of snoring according to Watch-PAT-200 and its relationship with the severity of obstructive sleep apnea syndrome. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology]. 2021; 86 (2): 38–42. DOI: https://doi.org/10.17116/otorino20218602138 (in Russian)

14. Zancanella E., do Prado L.F., de Carvalho L.B., et al. Home sleep apnea testing: an accuracy study. Sleep Breath. 2022; 26 (1): 117–23. DOI: https://doi.org/10.1007/s11325-021-02372-6

15. Agha M.A., Shehab-Eldin W., Helwac M.A. Obstructive sleep apnea in patients with type 2 diabetes mellitus. Egypt J Chest Dis Tuberc. 2019; 68 (4): 560–6.

16. Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019; 7 (8): 687–98. DOI: https://doi.org/10.1016/S2213-2600(19)30198-5

17. Abrams B. Use of blood biomarkers to screen for obstructive sleep apnea. Nat Sci Sleep. 2018; 10: 159–67.

18. Resta O., Foschino-Barbaro M.P., Legari G., Talamo S., et al. Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese subjects. Int J Obes. 2001; 25 (5): 669–75. DOI: https://doi.org/10.1038/sj.ijo.0801603

19. Nannapaneni S. Effect of obstructive sleep apnea on type 2 diabetes mellitus: a comprehensive literature review. World J Diabetes. 2013; 4 (6): 238–44. DOI: https://doi.org/10.4239/wjd.v4.i6.238

20. Seo M.H., Lee W.Y. Sleep disorder and cardiovascular risk factors in type 2 diabetes mellitus. Korean J Intern Med. 2011; 26 (3): 274–6.

21. Edmonds P.J., Gunasekaran K., Edmonds L.C. Neck grasp predicts obstructive sleep apnea in type 2 diabetes mellitus. Sleep Disorders. 2019; 2019: 3184382. DOI: https://doi.org/10.1155/2019/3184382

22. Mok Y., Tan C.W., Wong H.S., How C.H., et al. Obstructive sleep apnoea and type 2 diabetes mellitus: are they connected? Singapore Med J. 2017; 58 (4): 179–83. DOI: https://doi.org/10.11622/smedj.2017027

23. Montesi S.B., Edwards B.A., Malhotra A., Bakker J.P. Effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med. 2012; 8 (5): 587–96. DOI: https://doi.org/10.5664/jcsm.2170

24. Heffner J.E., Rozenfeld Y., Kai M., Stephens E.A., Brown LK. Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care. Chest. 2012; 141 (6): 1414–21. DOI: https://doi.org/10.1378/chest.11-1945

25. Davies M.J., Aroda V.R., Collins B.S., et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022: 65: 1925–66. DOI: https://doi.org/10.1007/s00125-022-05787-2

26. Kosseifi S., Bailey B., Price R., Roy T.M., et al. The association between obstructive sleep apnea syndrome and microvascular complications in well-controlled diabetic patients. Mil Med. 2010; 175 (11): 913–6. DOI: https://doi.org/10.7205/milmed-d-10-00131

27. Zhang R., Zhang P., Zhao F., Han X., Ji L. Association of diabetic microvascular complications and parameters of obstructive sleep apnea in patients with type 2 diabetes. Diabetes Technol Ther. 2016; 18 (7): 415–20. DOI: https://doi.org/10.1089/dia.2015.0433

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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