Thursday, May 8th, 2014
Obstructive sleep apnea (OSA) is a common disorder that is prevalent in people with Type 2 diabetes. It is characterized by upper airway instability during sleep, resulting in markedly reduced or absent airflow. People with untreated sleep apnea frequently stop breathing during their sleep, which results in fragmented, low quality sleep. Diabetic peripheral neuropathy (DPN) affects over 50% of people with diabetes. If left untreated, diabetic neuropathies trigger foot ulcers that may require amputation and cause disabling pain in the form of painful diabetic neuropathy. An interesting study by Tahrani and colleagues published in the American Journal of Respiratory and Critical Care Medicine (http://www.ncbi.nlm.nih.gov/pubmed/22723291) in 2012, evaluated the link between OSA and DPN from both clinical and pathophysiological perspectives. The prevalence of DPN was 60% in subjects with OSA and only 27% in those without OSA. The study identified increased nitrosative/oxidative stress and impaired microvascular regulation in OSA subjects. These are pathophysiological processes that may damage peripheral nerves and thereby cause DPN. The authors concluded by hypothesizing that OSA treatment, such as CPAP, may have therapeutic benefits in patients with DPN.