Cardiovascular concerns

Sleep apnea is associated with a number of problems involving the heart and blood vessels. For example, about half of all people with sleep apnea have high blood pressure. Data from the Wisconsin Sleep Cohort Study showed that people with mild sleep apnea (five to 15 events per hour) were twice as likely to develop hypertension as people who didn't have sleep apnea, and those who had 15 or more events per hour had three times the risk.

People with sleep apnea are also more likely to have coronary heart disease, which increases their risk of heart attacks. In addition, they are more likely to have a stroke and develop heart failure than people without this breathing disorder.

Researchers are not completely sure how sleep apnea affects the heart and blood vessels. There are a number of theories, but the body's response to the physiologic stress induced by sleep apnea—increased heart rate, narrowed blood vessels and a drop in oxygen levels—is likely to play a role.

Sleep Apnea Diagnosis and Treatment

If you have diabetes and are at risk for sleep apnea or your bed partner reports that you snore loudly or stop breathing when you're asleep or you wake up gasping or choking, talk to your doctor. He or she may request that you undergo a sleep study. During the test, a device records your brain activity, eye movement, muscle activity, breathing, heart rate, the amount of air that moves into your lungs and the oxygen concentration in your blood.

If sleep apnea is diagnosed and you're overweight (body mass index [BMI] is 25-29.9) or obese (BMI is 30 or higher), shedding pounds may help. In a 2009 report published in the Archives of Internal Medicine, researchers studied 264 obese men and women who had type 2 diabetes and obstructive sleep apnea. Half of the study subjects adopted an aggressive weight-loss regimen which included prescriptions for portion-controlled diets, physical activity and group sessions or social support, and they dropped 22 pounds, on average. Compared with others who lost little or no weight, the trimmed-down participants were three times more likely to have their sleep apnea go into complete remission after one year.

Other lifestyle measures, such as skipping alcohol before bed and taking steps to avoid sleeping on your back (such as sewing a tennis ball into the collar of your pajamas), may help, too.

The doctor also may recommend continuous positive airway pressure (CPAP) therapy, especially if you have moderate to severe sleep apnea. CPAP is administered using a device that consists of a nasal or facial mask that's connected by a tube to a small machine. The machine delivers a steady stream of air into the throat to maintain airway pressure and keep the airways open.

Does Treatment Help?

While some studies have found that using CPAP will help improve your diabetes, others have found no effect on glucose levels, but more studies are needed. However, a 2011 study in The New England Journal of Medicine found that even persons without diabetes who had moderate-to-severe sleep apnea and used the technology enjoyed a small drop in HbA1c, as well as reductions in blood pressure and total cholesterol.

Publication Review By: Rita Rastogi Kalyani, M.D., and Simeon Margolis, M.D., Ph.D.

Published: 24 Jul 2013

Last Modified: 11 Sep 2015