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Review
. 2023 Jul;23(7):165-171.
doi: 10.1007/s11892-023-01510-6. Epub 2023 May 6.

Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio

Soumya Kurnool  1 , Karen C McCowen  1 , Nicole A Bernstein  1 , Atul Malhotra  2
Affiliations
Review

Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio

Soumya Kurnool et al. Curr Diab Rep. 2023 Jul.

Abstract

Purpose of review: To synthesize the existing literature regarding the complex interplay between sleep disturbance, obesity, and diabetes. The review emphasizes the three pillars of health being diet, exercise, and sleep, with the notion that if one is ignored, then the other two could suffer.

Recent findings: Sleep deprivation is associated with incident obesity, perhaps mediated by dysregulation in leptin and ghrelin - hormones important in regulation of appetite. Sleep apnea is very common particularly among obese people with type 2 diabetes mellitus. Treatment of sleep apnea has clear symptomatic benefits although its impact on long-term cardiometabolic health is less clear. Sleep disturbance may be an important modifiable risk for patients at risk of cardiometabolic disease. An assessment of sleep health may be an important component of the comprehensive care of patients with obesity and diabetes mellitus.

Keywords: Apnea; Diabetes; Metabolic; Obesity; Sleep; Vascular.

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Conflict of interest statement

Dr. Malhotra is funded by the NIH. He reports income related to medical education from Livanova, Eli Lilly, Zoll, and Jazz. ResMed provided a philanthropic donation to UCSD. All the other authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Proposed interactions between T2DM, obesity, OSA, and NAFLD. Obesity is a known risk factor for T2DM, OSA, and NAFLD. T2DM is linked bidirectionally with OSA with some evidence that each factor may worsen the disease process of the other. OSA may in theory directly impact NAFLD. There is some evidence that treatment of OSA itself may lead to weight gain likely due to behavioral changes
See this image and copyright information in PMC

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