Diabetes, Sleep Apnea and Retinopathy: The Bad News Trio
A new study out of the University of Birmingham has found that patients who have both Type 2 diabetes and obstructive sleep apnea are at greater risk of going blind in 4 years or less. For these patients, this news is just one more reminder of how potentially serious these conditions really are.
Sleep apnea is a condition where, when you’re sleeping, the walls of your throat relax and narrow, causing you to snore and interrupting your breathing. As many as 40 to 50% of all Type 2 diabetes patients also suffer from diabetic retinopathy, the leading cause of blindness in the U.S.
Diabetic retinopathy, by the way, occurs when high blood sugar levels cause damage to blood vessels in the retina of the eye. The damaged blood vessels can swell and leak or they can close entirely, preventing blood from flowing through. This can lead to a loss of vision.
For many years, researchers have wondered about the link between retinopathy, diabetes and sleep apnea. Now those links have been verified.
Bottom line take away?
Patients with both sleep Apnea and Type 2 diabetes, compared with those suffering from diabetes alone, have a greater chance of developing advanced diabetes retinopathy within less than four years.
In other words, diabetics need to be on the constant alert for of any signs of sleep apnea. And if you’ve already been diagnosed with sleep apnea, consider this study a timely reminder that you see your eye doctor on a regular basis to find any signs of retinopathy in its earliest stages of development.
What Is Sleep Apnea?
It’s estimated that around 22 million Americans have obstructive sleep apnea, but 80% of moderate and severe cases go undiagnosed. Untreated, sleep apnea can lead to all kinds of health issues beyond just retinopathy. These include high blood pressure, chronic heart failure, atrial fibrillation, stoke, depression and other cardiovascular problems.
There are several different types of sleep apnea, I’ve discovered. Obstructive sleep apnea is caused by a blockage of the airway when, during sleep, the tongue collapses against the soft palate which then collapses against the throat. Complex sleep apnea, on the other hand, occurs when the airway is not fully blocked but the brain fails to signal breathing to resume. And finally, there’s complex sleep apnea. It combines the other two forms, but the brain only partially signals breathing to resume. This can happen many times during the sleep session, resulting in a disrupted sleep pattern that reduces oxygenation of the blood and negatively impacts the sleeper’s physical system.
Symptoms of Sleep Apnea:
- Loud snoring
- Awakening with a choking or gasping sensation
- Constant fatigue during the day
- Waking up with a very sore or dry throat
- Drowsiness while driving
- Morning headaches
- Restless sleep
- Forgetfulness, mood changes, and decreased interest in sex
- Recurrent awakenings or insomnia
Any of these symptoms sound like your own sleep pattern? If so, don’t put off checking with your physician to find out exactly what’s going on with you.
Treatment for Sleep Apnea
If you suspect you have sleep apnea, your first step in getting treatment should be to undergo a sleep study. This can be set up by your physician at a qualified sleep lab. Typically, you’ll check into the lab for an overnight session during which you’ll be monitored for a number of criteria. The lab will be looking at your sleep blood oxygen levels, respiration rates, brain-wave activity, leg movement, and most important, the apnea-hypopnea index, which is the number of partial inhalation incidents you have per hour. Some labs offer a home version of these studies, others require you to check into their facilities.
I remember that when I had this study conducted on myself, I checked into a very nice, almost hotel-like room at the lab. They hooked up all kinds of monitors and leads to my head and torso, and wished me a good night’s sleep. I fell asleep quickly, but almost instantly (or so it seemed) they were asking me to turn over on my back. A few minutes later, they wanted me to turn on my side. Frankly, the idea that someone (actually a small crew) of technicians were eyeballing me so closely while I slept was kind of spooky. I remember thinking, “Gee, I hope I don’t snort or drool.”
Apparently I did snort and maybe a bit more, because the night was not very far along when the technician’s voice over the speaker informed me that she was concluding the study, and that I was indeed one of “their boys.”
Meaning I had sleep apnea.
My treatment began a few days later when I was given a CPAP (Continuous Positive Airway Pressure) machine that blew a mild stream of air into my nose so that my airways remained open while I slept. It was a bit challenging to get used to at first but eventually I came to accept it as part of my normal sleep routine.
Don’t get me wrong: having a machine blow air up your nose all night long is neither natural nor entirely comfortable. But considering the possible complications that can arise from untreated sleep apnea, it’s something I and thousands of others have learned to put up with. In my case, the sleep study and the cost of CPAP equipment was all covered by my group insurance policy.
So yes, this University of Birmingham study looking into the ways that sleep apnea plus diabetes affected the development of eye problems certainly spoke to me. It’s bad enough I have to suffer all the side effects of diabetes as well as a sleep disorder, but potential blindness, as well?
I’m staying close to my eye doctor going forward, aren’t you?