SLEEP PATTERNS IN OBESE PATIENTS WITH DIABETES

Obesity is a fastest growing epidemic and is associated with diseases like diabetes. It is expected that 425 million people are living with Diabetes and obesity worldwide; which is approximately to be 1 in 10 people worldwide. Sleep disorders in these people can aggravate their risk for cardiovascular events. This leads to a substantial burden on healthcare systems world-wide and cause a great burden economically especially in developing countries with limited health resources.

Discussion: In our study we found a higher incidence of OSA in obese diabetics. It is a well-established fact that obesity itself is a major risk factor for metabolic syndrome which leads to diabetes. Many patients with diabetes have poor sleep quality, leading to anxiety experienced due to dyspnea affects the sleep quality and the sleep quality has effects on physical and emotional functions. COPD-related sleep disturbances play a role in its morbidity and adversely affect quality of life. The presence of obesity may further adversely affect the sleep quality in COPD patients. Kwon JS et al, had postulated that patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (known as overlap syndrome) who have more severe lung disease, as measured by lung hyperinflation (inspiratory capacity/total lung capacity), would have greater sleep disturbances independent of traditional measures of sleep apnea.

Conclusion: Over-weight and obese diabetics have a high chance of developing OSA (obstructive sleep apnea).OSA  is associated with intermittent hypoxemia causing release of ROS (reactive oxygen species) and inflammatory state leading to pulmonary hypertension. In my study all patients had nocturnal hypoxemia. OSA together with other co-morbidities can cause right ventricular strain and failure. Very often OSA can go undetected as they may not have gross symptoms. Thus early detection of sleep abnormalities in obese people is necessary to manage and prevent its complications and co-morbidities

Author(s): Sarang Patil

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