Wil Dubois

Hey There, welcome back to Ask D'Mine, our weekly advice column hosted by Wil Dubois in New Mexico, a veteran type 1 and diabetes author with experience working as a clinical diabetes specialist. This week, a reader is finally stumping Wil with a question he can't quite answer.

Or can he...?

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Jen, D-mom from Wisconsin, writes: Shot in the dark here. Know any families also battling sleep disordered breathing and type 1? My son is, and finally feeling rested over winter break, sleeping 13-14 hours!! Been doing that for a week. I thought if anyone has run across that it is you!!

 

[email protected] D’Mine answers: Actually Jen, yours is the first family I’ve heard of with this issue in a type 1 kiddo, although a sleep breathing problem called sleep apnea is super-common amongst our type 2 cousins. In an unscientific nutshell, here’s what happens with that type of disordered breathing: As the unsuspecting victim falls asleep, so too does his or her throat muscles. Well, at least the muscles chill more than they are supposed to, letting the tongue fall backwards into the throat, blocking off the airway momentarily. This cuts off the oxygen to the brain and the brain triggers a fire alarm to wake everybody back up.

Actually, the whole process rarely completely wakes up the person suffering from sleep apnea; rather, it prevents them from ever getting into proper deep sleep, no matter how many hours they are in the sack.

The tongue drop can happen a couple of times a night, or in severe cases, people with sleep apnea can suffer hundreds of “episodes” a night! Sounds awful, doesn’t it?

Luckily the most common cure is fairly simple and highly effective: A face mask that lets loose your inner fighter-pilot fantasies is connected to a little machine, commonly called a CPAP, that maintains positive airway pressure to keep the airway open all night, resulting in a restful night’s sleep. Sleeping with such a contraption seems onerous, but everyone I know who has one also swears by it the way NRA folks swear by their guns: "You can take my CPAP machine away when you pry it from my cold, dead hands."CPAP machine

So I guess they work pretty damn well. 

Sleep apnea is common enough in type 2s, and type 2 is common enough in sleep apnea patients that a consensus statement from the International Diabetes Association basically says, if you find one, you should test for the other. 

What do the numbers look like? In the latest research I could find, 30% of type 2s also have some degree of sleep apnea. So it’s pretty common. But what’s the connection? Does type 2 diabetes increase the risk of sleep apnea, or does sleep apnea increase the risk of type 2 diabetes? That’s highly debatable, and is highly debated, but at least one recent study that looked at over 8,000 adults who underwent sleep studies (the test for sleep apnea) and then followed them over a decade, finding that folks with sleep apnea had a greater chance of developing type 2 diabetes than folks who didn’t have sleep apnea; and additionally that the more severe the sleep apnea was, the higher the diabetes risk, which at least suggests that the apnea comes first.

But what about type 1s? Well, sleep apnea may be equally common in type 1s, at least for some subset of us, according to data released at the ADA’s 2015 Scientific Sessions in Boston. A study in France looked at 90 type 1s and found sleep apnea in 39 of them. That’s 43%, higher than the best estimate of the prevalence of sleep apnea in type 2s! But what makes this particular study interesting is that unlike type 2 sleep apnea, there was no correlation between the sleep apnea and body mass index (BMI).

Oh, right. I forgot to mention that the risk of sleep apnea in type 2s and sugar-normals increases with weight. Crudely put, the fatter you are, the more likely your tongue will try to choke you in the middle of the night when you are alseep.

But unlike your son, the sleep apnea in the type 1s was found in those who’ve had diabetes for a looooong time (more than 20 years), and was also more common in PWDs with neuropathy, which actually made me wonder if it was really even the same apnea type 2s get. And speaking of age, which we were indirectly by talking about your son, traditional sleep apnea typically strikes older folks, although it is seen occasionally in adolescents with very high BMIs.

So given all of that, while sleep breathing problems seem to be part and parcel of the diabetes experience for both type 2s and type 1s, and while a small number of young people are also at risk, a young type 1 doesn’t appear to me to be in the obvious cross hairs for any flavor of apnea.

But if not sleep apnea, then what? Well, here’s my shot in the dark: Let’s not forget that teens need more sleep than either younger or older people do. The teen metabolism is estimated to require nine and a quarter hours of sleep a night, but most of them only get seven due to school schedules, social activities, and digital temptations. It could just be that his body was using winter break to “catch up” on sleep. 

Still, I don’t see any harm in the sleep study; although I’m skeptical that it will find anything. He might just need to go to bed earlier.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.