Clinical Investigations

Autonomic Neuropathy Increases the Risk of Obstructive Sleep Apnea in Obese Diabetics
Paolo Bottini^a, Stefania Redolfi^b, Marco L. Dottorini^a, Claudio Tantucci<sup>b

a</sup>Division of Internal Medicine, Hospital of Umbertide, Perugia, and
^bRespiratory Medicine Unit, Department of Medicine, University of Brescia, Brescia, Italy

Address of Corresponding Author

Respiration 2008;75:265-271 (DOI: 10.1159/000100556)

  Key Words

• Obstructive sleep apnea
• Obesity
• Diabetes
• Autonomic neuropathy

  Abstract

Background: Nonobese diabetics with diabetic autonomic neuropathy (DAN) show an elevated prevalence of obstructive sleep apnea-hypopnea (OSAH). Objective: It was the aim of this study to assess if the presence of DAN could further increase the risk of developing OSAH in obese diabetics. Methods: Eighteen obese diabetic patients, 8 with DAN [age 57 ± 5 years, body mass index (BMI) 35 ± 4] and 10 without DAN (age 56 ± 8 years, BMI 37 ± 5), were recruited. Ten age-matched obese subjects were studied as controls (age 53 ± 12 years, BMI 34 ± 3). All subjects underwent a cardiorespiratory sleep study in the in-hospital sleep laboratory to obtain the apnea-hypopnea index (AHI) and oxygen desaturation indices. Results: Diabetics with DAN (Ob-DAN+) had a higher AHI than diabetics without DAN (Ob-DAN-) and controls, amounting to 39.5 ± 13 versus 15.8 ± 12 (p < 0.01) and 19.3 ± 21 (p < 0.05), respectively. A moderate-to-severe OSAH (AHI 15) occurred in all Ob-DAN+ and only in 4 Ob-DAN- and 4 control patients. Moreover, the indices reflecting the impairment of oxygen saturation (SaO₂) during sleep such as the mean lowest SaO₂ and sleep time with a SaO₂ <90% were more severely affected in Ob-DAN+ patients compared with the other groups and were associated with longer obstructive respiratory events. Conclusions: Apneas-hypopneas are more frequent and last longer in Ob-DAN+ than in other obese subjects, with or without diabetes.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Prof. Claudio Tantucci
I Medicina, Spedali Civili di Brescia
P.zzale Spedali Civili, 1
IT-25100 Brescia (Italy)
Tel./Fax +39 030 39 80 69, E-Mail tantucci@med.unibs.it

  Article Information

Received: August 2, 2006
Accepted after revision: January 9, 2007
Published online: March 7, 2007
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 3, Number of References : 41