Scientific evidence shows that there is a connection between sleep disturbances, such as insomnia or sleep apnoea, and type 2 diabetes. Not only can insomnia and sleep apnoea increase the risk of developing type 2 diabetes, but people already diagnosed with diabetes may find their blood glucose levels are elevated after a restless sleep.

Insomnia

Insomnia can include several types of sleep disruption, including:

• Trouble falling asleep
• Difficulty staying asleep
• Waking early
• Waking unrefreshed

Causes of insomnia

There may be many reasons for insomnia. Common reasons are discomfort and/or frequent urination related to elevated blood glucose levels, stress, medications, and/or lack of physical activity. Insomnia, like other sleep disorders, often goes undiagnosed. If you have diabetes, it’s important to talk with your GP about your sleep patterns, and be assessed for insomnia.

Sleep apnoea

There are several types of sleep apnoea, the most common is obstructive sleep apnoea. This type of sleep apnoea occurs when the throat and tongue muscles intermittently relax and block the airway during sleep. This causes long pauses in breathing, creating a significant lack of oxygen (hypoxia). Research has consistently shown that sleep apnoea can cause increased insulin resistance, oxidative stress, inflammation and alter glucose metabolism. There is also significant evidence to show that sleep apnoea increases the risk of diabetes complications such as hypertension, atherosclerosis, dyslipidemia, cardiovascular disease, and neuropathy.

Risk factors

Factors that increase the risk of this form of sleep apnoea include:

• Excess weight
• A narrowed airway
• Age (older adults)
• Family history
• Use of alcohol
• Smoking
• Nasal congestion
• Medical conditions

Symptoms of obstructive sleep apnoea include

• Loud snoring
• Observed episodes of stopped breathing during sleep
• Abrupt waking at night accompanied by gasping or choking
• Night time sweating
• Waking with a morning headache
• Difficulty concentrating during the day
• Waking with a dry mouth
• High blood pressure

Testing for sleep apnoea

To receive a diagnosis of sleep apnoea you will need to undergo some non-invasive testing procedures. Sleep studies or at home diagnostic sleep apnoea tests can measure breathing patterns, oxygen levels, heart rate and body movement while you sleep. Ask your GP for more information about the referral process and Medicare rebate eligibility for testing if you have sleep concerns.

Treatment of sleep apnoea

Often minor sleep issues can be resolved by making changes to your daily routine or by paying attention to diet, stress levels, weight management and exercise.

A device called a Continuous Positive Airway Pressure (CPAP) can be used to help with sleep apnoea. This device is like a small air compressor. It uses a mask or nosepiece to deliver a constant, steady air pressure which keeps the airways open and sends valuable oxygen into the nose and mouth while you sleep. Along with medication (if required) and dietary changes, a CPAP device can help you get quality sleep, and bring blood glucose levels back into safe range.

Eligibility for rebates

If you’ve been diagnosed with sleep apnoea you may be eligible for a 3-month trial of the CPAP device under Medicare subsidy. In some circumstances, if your GP reports that the device is alleviating your symptoms, Medicare may extend the cover. However, we suggest that you speak to your GP about receiving Medicare rebates, as Government funding and eligibility criteria is different between states.  Some private Health Insurance funds pay rebates toward the CPAP device, so check with your health fund for accurate details and quotes.

Early recognition and intervention can greatly assist with sleep apnoea and insomnia. It’s important to discuss any sleep-related issues with your GP.

Helen Jackson -APD-CDE