Sticking it to sleep

A study is hoping to find treating sleep apnea can help type 2 diabetics

A study is hoping to find treating sleep apnea can help type 2 diabetics

June 08, 2009|By CRYSTAL SCHELLE

Just breathe.

Air might be the next tool to help type 2 diabetics control their diabetes.

Dr. Naresh M. Punjabi, principal investigator, said the Johns Hopkins University's Hagerstown field center is conducting a trial to find out if a type 2 diabetic using a continuous positive airway pressure (CPAP) machine to treat sleep apnea can improve blood glucose control.

A CPAP machine increases air pressure in a person's throat to help with breathing during sleep.

Punjabi said diabetics already know such things as eating right and getting exercise help control blood glucose levels. Less obvious is that getting a good night's sleep might also affect diabetic health.

Sponsored by ResMed Corp., a manufacturer of CPAP machines, the study is seeking about 50 participants in Hagerstown. Punjabi estimated that five are currently enrolled.


The study is being simultaneously conducted in Baltimore at Johns Hopkins Bayview Medical Center, as well as in other parts of the United States and in Australia.

Punjabi said sleep apnea is fairly common. About 24 percent of men in the United States have sleep apnea, while 9 percent of women do, he said.

About sleep apnea

Melissa Minotti, research program coordinator and registered polysomnographic technologist, said after menopause, women are actually at a greater risk for sleep apnea.

Normal breathing during sleep is slow, deep and regular. Sleep apnea is a condition in which a person stops breathing several times during the night or has shallow breathing.

"It can be as much as once a minute for those who have severe apnea," Minotti said.

Obesity is seen in a majority of patients who suffer from sleep apnea, Punjabi said. Obesity also plays a role in type 2 diabetes.

"Not getting enough sleep can indirectly affect all aspects of a person's life," he said.

He said diabetics know that exercise is one way to maintain blood glucose control.

"We know the key is exercise, but if you get up the next day and you get up after not sleeping well, you're not going to feel like exercising," he said.

People who have undiagnosed sleep apnea have decreased oxygen levels. Punjabi said they are more likely to be at risk for auto accidents and might also have decreased cognitive skills.

Who qualifies

The study will last about seven months. Minotti said men or women who qualify to volunteer for the study will be paid a small stipend, as much as $450.

In order to be part of the study, Minotti said patients must meet criteria:

o 18 or older

o Type 2 diabetic and not insulin dependent

o Have a body mass index less than 40

o On stable medications for at least the past three months

o Not currently a part of sleep therapy

Minotti said participants will be broken into two groups. Both groups will receive lifestyle and nutrition counseling. However, only one group will get a CPAP machine.

Those who apply for the study will come in first for a pre-screening, Minotti explained, which includes blood work. And if a person does have sleep apnea, Minotti said they'll decide if the sleep apnea is severe enough to be useful for the study.

How the study works

After the person qualifies, Minotti said, the next part of the study happens in the comfort of the person's home. All participants go through a sleep study.

During the one-night study, the participant sleeps in his or her own bed. Researchers attach sensors on the body to measure such things as brain waves, eye movements and breathing and whether a person has leg kicks during sleep. It is a diagnositic tool to see if the person has apnea.

"They'll wear it during the night. We'll come over, hook it up and leave," Minotti said.

Minotti said the sleep study machines are portable. People can watch TV while hooked up, then go to bed.

Those who qualify for the study will be given a CPAP to use at home. They will undergo routine blood work and other simple tests. They will also be supplied with a glucose meter plus testing strips and blood-sample lances. At the end of the study, the person can keep the meter.

The future

Punjabi and Minotti are hoping this study will lead to a better quality of life for those who are diabetic and have sleep apnea.

"This will have a broad implication on how to treat diabetes," Minotti said.

Looking for sleep apnea in type 2 diabetics, Punjabi said, can help in a diabetic's overall health.

Punjabi said the best thing about treating sleep apnea is that there's nothing toxic about the treatment.

"It's basically just air pressure," he said.

For more information ...

o To be a part of the Johns Hopkins University's Hagerstown field center's study, call Melissa Minotti at 301-791-1847, ext. 110.

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