Researchers assess impact of sleep apnea treatment on diabetes management

For adults with diabetes, managing the disease is a day-in, day-out effort to control the factors that affect blood sugar levels. A team of scientists, including two West Virginia University professors, is researching how one aspect of a patient's daily routine could help keep blood sugar levels within a specific range.

Robert Stansbury, assistant professor in the WVU School of Medicine, is working as part of a multi-center project sponsored by the National Institutes of Health to assess what impact treating obstructive sleep apnea has on diabetes self-management.

Characterized by interrupted breathing during sleep, obstructive sleep apnea is a common disease linked to a range of problems in diabetics and non-diabetics alike-;from poor work performance to heart failure. It can even make diabetic patients less sensitive to insulin.

One of the most common treatments for the disease is called continuous positive airway pressure therapy or CPAP. This treatment often requires the use of a CPAP breathing machine at night, which blows air through a patient's airway at a constant pressure to help keep the airway open.

What's not yet understood is if treating sleep apnea equips patients to manage their own diabetes better.

Stansbury, who also serves as the interim section chief of pulmonary, critical care and sleep medicine at WVU, is working with Jessica Perini, assistant professor in the WVU School of Medicine, and colleagues from the University of Pittsburgh, the Pittsburgh Veterans Administration Medical Center and the John D. Dingell Veterans Administration Medical Center in Detroit to oversee two informational sessions on diabetes self-management, which approximately 120 diabetic sleep apnea patients will attend.

During the 12-week study, half of the patients will use a CPAP machine to treat their sleep apnea; the others will use a mock CPAP machine that looks and feels like a regular machine but does not impart any of its benefits. Both groups will undergo periodic blood sugar checks by the research team. They will also note how frequently they check their own blood sugar, take a quiz on what they learned at the informational sessions and wear pedometers to monitor how many steps they take.

"It's a little bit of a step forward from previous studies because previous ones looked at insulin sensitivity and glycemic control, but this one is looking at self-management as well," Stansbury said. "Are they putting more effort toward it and better recalling the information provided to them at the diabetes education sessions?"

If the study shows that using CPAP machines improves blood-sugar control in diabetic sleep-apnea patients, "we will have no excuse for not screening more of our diabetics for sleep apnea," Perini said.

As for diabetics who already have a sleep apnea diagnosis, the study may arm healthcare providers with information to persuade them to use their CPAP machines regularly.

"People with diabetes struggle so much with their sugars that there may be a sense of relief that comes with knowing there can be at least some help simply by using their CPAP," Perini said.

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