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April2013 Vol.50 Issue:        2        Table of Contents
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Sleep Apnea in Patients with Diabetic Neuropathy

Yossri Ashour1, Ahmed Abou-Hagar1, Nihal  El-Shazly2, Waleed  Al-Deeb1,

Reda Ahmed1, Saly El-Kholy2, Ahmed Osama1

Departments of Neuropsychiatry1, Suez Canal University; Clinical Neurophysiology2, Cairo University; Egypt



Background: Diabetes mellitus (DM) is a major chronic disease with high morbidity, mortality and economic burden. Sleep apnea is an increasingly recognized medical problem with its important role in metabolic, vascular and behavioral aspects. Association between sleep apnea and DM is likely to be complex. Objective: To detect prevalence, type and severity of sleep apnea in diabetic patients, and to detect any relation between sleep apnea and diabetic state, diabetic peripheral and autonomic neuropathy and phrenic nerve affection. Methods: Forty four diabetic patients were included in the study. Another 44 age and sex matched healthy subjects representing the control group were included. All the subjects were evaluated for diabetic state, peripheral neuropathy, autonomic neuropathy, phrenic nerve affection and sleep disorders. Results: High scores of the Epworth Sleepiness scale (≥10) and sleep apnea were significantly more frequent in diabetic patients (63.6% and 84.1% respectively). Obstructive sleep apnea was the most frequent type (65.9%) followed by mixed type (13.7%) and lastly central sleep apnea (4.5%). All the grades of sleep apneas (mild, moderate and sever) were highly significantly more frequent in diabetics than in non diabetics (P<0.01). There was significant relation between sleep apnea and age of the patient, male sex, uncontrolled DM, duration of DM, diabetic autonomic neuropathy and phrenic nerve affection. There was no relation detected between sleep apnea and diabetic peripheral neuropathy. Conclusion:  Sleep apneas as well as changes in sleep architecture were more frequent in diabetic patients with autonomic neuropathy and phrenic nerve affection. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(2): 187-193]

 Key Words: Sleep apnea, diabetes mellitus, neuropathy, phrenic nerve, polysomnography.

Correspondence  to  Yossri  Ashour, Neurology Unit, Suez Canal University, Ismailia, Egypt.Tel.: +201143541776      e-mail:

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