Henriette Holst Hansen1, Lise Tarnow1,4, Ulrik Pedersen-Bjergaard1, Brynjulf Mortensen2, Michael Laub3 og Birger Thorsteinsson1,5
1Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital ? Hillerød, 2Steno Diabetes Center,3Respiration Center East, 4Health, Aarhus University, 5Faculty of Health and Medical Sciences, University of Copenhagen
Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital ? Hillerød
Hypotese og formål:
Obstructive sleep apnea (OSA) is a disorder associated with excessive daytime sleepiness, reduced quality of life and increased cardiovascular morbidity and mortality. Previous studies have reported higher prevalence of OSA in patients with Type 2 Diabetes compared to the background population (below 5%)? partly due to obesity. A possible association between OSA and Type 1 Diabetes (T1D) has so far not been investigated, and therefore the aim of this study is to describe the prevalence of OSA in a large, well-characterized cohort of Danish T1D patients.
A total of 52 T1D patients have so far participated in the study. The patients were examined for OSA with the ApneaLink+, a home-sleep-diagnostic device. OSA was defined as an apnea-hypopnea index (AHI) equal to or above 5 episodes/hour and was stratified as mild (AHI: 5-15), moderate (AHI: 15-30) and severe (AHI ≥ 30). Symptoms of OSA were scored using the Epworth Sleepiness Score and the Berlin questionnaire. Clinical data were collected on age, gender, duration of diabetes, BMI, and HbA1c.
Only 45% (n=22) of the examined patients had normal respiration during sleep. Thirty-nine percent of the patients (n=19) had mild OSA, 6% (n=3) had moderate OSA and 4% (n=2) had severe OSA. Furthermore, 3 patients were already diagnosed with OSA, and another 3 patients showed signs of Cheyne-Stokes respiration.
Patients with OSA were older (58.1±10.9 years (mean±SD)) than patients with normal nighttime breathing (46.1±16.0 years) (p= 0.003), but were otherwise comparable with respect to gender (70% vs. 68% men), duration of diabetes (23.9±13.8 vs. 21.6 ±12.0 years), BMI (25.4±2.8 vs. 25.0±3.2 kg/m2) and HbA1c (7.6±0.8 vs. 7.9±0.8 %), respectively.
Patients with OSA were more likely to report observed apnea episodes (15% vs. 0%) and snoring (93% vs. 73%), but were not more tired during daytime (26% vs. 38%) in comparison with patients with normal nighttime breathing.
Our preliminary results indicate a high prevalence of especially mild OSA in Danish patients with T1D, even in the absence of obesity. Our data also suggest that classical symptoms do not reliably identify patients with OSA and Type 1 Diabetes.