Elsevier

Diabetes & Metabolism

Volume 35, Issue 5, November 2009, Pages 372-377
Diabetes & Metabolism

Original article
Prevalence and predictive factors of sleep apnoea syndrome in type 2 diabetic patientsPrévalence et facteurs prédictifs de syndrome d’apnées du sommeil chez des patients présentant un diabète de type 2

https://doi.org/10.1016/j.diabet.2009.03.007Get rights and content

Abstract

Aim

This study aimed to assess the prevalence and characteristics of sleep apnoea syndrome (SAS) in patients hospitalized for poorly controlled type 2 diabetes.

Methods

An overnight ventilatory polygraphic study was systematically performed in 303 consecutive patients.

Results

Overall, 34% of these patients had mild SAS, as defined by a respiratory disturbance index (RDI) of 5–15; 19% had moderate SAS (RDI: 16–29) and 10% had severe SAS (RDI  30). The SAS was obstructive in 99% of the apnoeic patients. The percentage of patients with excessive daytime sleepiness (Epworth sleepiness scale > 10), fatigue or nocturia did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. The percentage of patients who snored was significantly higher in patients with severe or moderate SAS versus non-apnoeic patients. HbA1c, duration of diabetes and the prevalences of microalbuminuria, retinopathy and peripheral neuropathy did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. However, patients with severe or moderate SAS had significantly higher values for body mass index, waist circumference and neck circumference than non-apnoeic patients.

Conclusion

In type 2 diabetic patients with poor diabetic control, obstructive SAS is highly prevalent and related to abdominal obesity, and should be systematically screened for, as it cannot be predicted by the clinical data.

Résumé

Objectifs

Évaluer la prévalence et les caractéristiques du syndrome d’apnées du sommeil (SAS) chez des patients hospitalisés pour un diabète de type 2 mal équilibré.

Méthodes

Une polygraphie ventilatoire a été réalisée chez 303 patients consécutifs.

Résultats

Trente-quatre pour cent des patients avaient un SAS léger défini par un index d’apnées-hypopnées (IAH) entre 5 et 15, 19 % un SAS modéré (IAH: 16–29) et 10 % un SAS sévère (IAH  30). Il s’agissait d’un SAS obstructif dans 99 % des cas. Le pourcentage des patients présentant une somnolence diurne excessive (score d’Epworth > 10), une fatigue ou une nycturie ne différait pas significativement entre les patients ayant un SAS sévère, modéré ou léger et les non apnéiques. Le pourcentage de ronfleurs était significativement plus élevé chez les patients ayant un SAS sévère ou modéré que chez les non apnéiques. L’HbA1c, l’ancienneté du diabète et la présence d’une microalbuminurie, d’une rétinopathie et d’une neuropathie périphérique ne différaient pas significativement entre les patients ayant un SAS sévère, modéré ou léger et les non apnéiques. Les patients qui avaient un SAS sévère ou modéré avaient un indice de masse corporelle, un tour de taille et un périmètre cervical significativement plus élevés que les non apnéiques.

Conclusion

La prévalence du SAS est élevée chez les patients atteints d’un diabète de type 2 mal équilibré et est associée à l’obésité abdominale. Le SAS devrait être dépisté systématiquement chez ces patients car les données cliniques ne permettent pas d’en prédire la présence.

Section snippets

Study population

Participation in the present study was proposed to all patients admitted over a 6-month period—from January to June 2007—to the Department of Diabetology at our hospital with poorly controlled type 2 diabetes, as assessed by one hospital staff doctor during an outpatients visit. The diabetic patients found to be poorly controlled (based on clinical and biological data) were hospitalized for an average of 1 to 5 days for various clinical examinations and patient education.

Every hospitalized

Results

A total of 362 patients with type 2 diabetes were hospitalized during the study period because of poor diabetic control, of which 23 (6%) had already been diagnosed with sleep apnoea. Thirty-two patients fulfilled the exclusion criteria and were excluded. Also, in four cases, it was impossible to analyze the polygraphy due to technical failure. The remaining 303 patients (156 men, 147 women) were finally included in the study.

The prevalence of newly diagnosed SAS was 63% (191/303) in these

Discussion

In the present study, we systematically performed nocturnal respiratory polygraphic studies in 303 patients consecutively admitted to hospital because of poorly controlled type 2 diabetes. We found that the prevalence of previously undiagnosed SAS was high in these patients, reaching 63%. Also, nearly all of the apnoeic patients had the obstructive form of the condition, whereas the prevalence of obstructive SAS in the general population is much lower, ranging from 2 to 9% [16]. In addition,

Conflicts of interests

The authors do not have any conflict of interests to declare regarding the present study.

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