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: yossri_a@hotmail.com