Obstructive sleep apnea is associated with diabetic peripheral neuropathy

June 15, 2012

Obstructive sleep apnea (OSA) is independently associated with diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM), according to a new study from researchers in the UK. The severity of DPN is also correlated with the degree of OSA and the severity of nocturnal hypoxemia.

"OSA is known to be associated with inflammation and oxidative stress, so we hypothesized that it would be associated with peripheral neuropathy in patients with T2DM," said lead author Abd Tahrani, MD, clinical lecturer in endocrinology and diabetes at the University of Birmingham in the UK. "This is the first report to identify an independent association between OSA and DPN in these patients."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and .

In the observational cross-sectional study, DPN was assessed with the Michigan Neuropathy Screening instrument in 234 adults with T2DM. OSA was assessed with a single overnight home-based cardio-respiratory sleep study using a portable multi-channel device.

OSA was independently associated with DPN even after adjustment for a number of possible confounders, including ethnicity, gender, age at diabetes diagnosis, and diabetes duration, and remained independently associated with DPN after further adjustment for obesity and other risk factors for DPN. In addition, DPN severity was significantly correlated with OSA severity and nocturnal hypoxemia severity. The relationship between OSA severity and DPN severity remained significant after adjustment for age, obesity, diabetes duration, gender and estimated .

The researchers also found that OSA was associated with increased nitrosative/oxidative stress and impaired microvascular blood flow regulation, which could explain the relationship observed between OSA and DPN. "In patients with T2DM, OSA may aggravate and amplify glucose toxicity, which has significant implications for tissues which are susceptible to the complications of diabetes," said Dr. Tahrani.

The study had some limitations, including its cross-sectional design and lack of an interventional arm, making proof of causation necessary in additional prospective studies.

"Additional prospective and interventional studies are also needed to examine the role of OSA and intermittent hypoxemia in the development and progression of DPN in patients with both early and advanced , and to assess the potential impact of continuous positive airway pressure (CPAP) treatment on DPN," Dr. Tahrani said.

Explore further: Diabetic polyneuropathy not up with impaired glycemia

Related Stories

Diabetic polyneuropathy not up with impaired glycemia

March 3, 2012
(HealthDay) -- Although significantly increased in subjects with new diabetes, the rates of typical diabetic polyneuropathy (DPN), retinopathy, and nephropathy are not significantly different between subjects with and without ...

Severity of sleep disordered breathing predicts glycemic health

May 23, 2012
The severity of sleep disordered breathing and nocturnal hypoxemia independently predict both glycosylated hemoglobin (HbA1c) levels and type 2 diabetes mellitus (T2DM), according to a new study.

Prediabetes may not explain diabetic polyneuropathies

February 22, 2012
In a reversal of two decades of medical reports, a Mayo Clinic study finds the frequency of nerve damage called diabetic polyneuropathy is similar in prediabetic patients and healthy people. Physicians should seek explanations ...

Recommended for you

Anti-nausea drug could help treat sleep apnea

June 6, 2017
An old pharmaceutical product may be a new treatment for obstructive sleep apnea, according to new research presented today by University of Illinois at Chicago and Northwestern University scientists at the SLEEP 2017 annual ...

New disposable, wearable patch found to effectively detect sleep apnea

June 4, 2017
Results of a definitive clinical trial show that a new, disposable diagnostic patch effectively detects obstructive sleep apnea across all severity levels.

Childhood sleep apnoea is common but hard to diagnose

April 28, 2017
The cessation of breathing during sleep caused by enlarged tonsils is common in preschool-age children and can cause serious complications, but the methods normally used to diagnose the condition are subjective and unreliable. ...

Curbing sleep apnea might mean fewer night trips to bathroom

March 27, 2017
(HealthDay)—Millions of Americans battle bothersome nighttime conditions, such as sleep apnea or the need to get up frequently to urinate.

Untreated sleep apnea in children can harm brain cells tied to cognition and mood

March 17, 2017
A study comparing children between 7 and 11 years of age who have moderate or severe obstructive sleep apnea to children the same age who slept normally, found significant reductions of gray matter - brain cells involved ...

Dietary supplement derived from tree bark shows promise for treating obstructive sleep apnea

February 24, 2017
Obstructive sleep apnea, which causes people to briefly stop breathing while asleep, affects an estimated 5 percent of the population, not including the many more who don't even realize they suffer from the disorder.

3 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

Tom_Hennessy
not rated yet Jun 15, 2012
Obstructive Sleep Apnea OSA and Diabetic Neuropathy share a characteristic. Increased red blood cells / erythrocytosis / polycythemia.
"Secondary polycythemia due to obstructive sleep apnea"
"Increased red blood cell count could be considered as a new aspect of the insulin resistance syndrome"

tadchem
not rated yet Jun 15, 2012
So does one cause the other? Of so, which causes which?
Or is there a common cause for both?
Can this kind of research even determine causality, or is it merely a data mining discovery using freshman statistics?
Tom_Hennessy
not rated yet Jun 15, 2012
Erythropoietin doping for elite athletes , raises red blood cells , and they manifest apnea.

Phlebotomy is the only treatment of any use in those with COPD who also , coincidentally manifests erythrocytosis and sleep apnea.
"COPD and sleep apnea-hypopnea syndrome"

"Phlebotomy decreases blood volume and viscosity, increases cardiac output and improves exercise tolerance in patients"
"Improvement was dramatic"

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.