Several recent studies have shown that, when it comes to OSA, diabetics are at high risk for complications – especially in their eyes. Untreated sleep apnea increases the risks for several kinds of diabetic eye disease, including macular edema and diabetic retinopathy.
In October 2021, a presentation at the American Society of Retina Specialists Annual Meeting highlighted the link between untreated OSA and diabetic retinopathy and recalcitrant retinal vascular disease.
In the study, a diagnosis of retinal issues in a patient with diabetes was followed by a diagnosis of obstructive sleep apnea 86% of the time, so there was a clear indication that the conditions are linked somehow. In addition, 39% of those diagnosed with OSA were not yet obese. These are patients who might not have been screened and treated if it wasn’t for the diagnosis of retinopathy.
The good news is that getting treatment for OSA stopped or slowed the progression of eye disease in many of the patients. However, this suggests that untreated OSA may have contributed to the disease in the first place. In addition, untreated OSA was associated with more kidney damage and worse blood sugar control in diabetics.
What does this mean for diabetics?
If you have diabetes and are beginning to experience retinopathy, get a sleep study. There is a good chance that OSA is contributing to your condition. In fact, a sleep study should immediately follow any new diagnosis of type II diabetes or high blood pressure.
If you have OSA and have not been able to comply with your prescribed CPAP treatments, look for treatment alternatives, such as an oral appliance. Treatment only works if you use it, so a treatment that you use every night is going to have better effects than one that sits unused on your bedside table.
Finally, even if you’re not obese, if you notice that your blood pressure, cholesterol, or blood sugar numbers are starting to rise, get a sleep study. It’s easier to prevent the OSA disease process than it is to reverse it.
What does this mean for practitioners of dental sleep medicine?
Whenever one of your patients has a new diagnosis of type II diabetes, diabetic retinopathy, or loss of kidney function, get them screened, diagnosed, and treated. OSA treatment is essential for the proper management of type II diabetes.
If you’d like to know more about how sleep impacts whole-body health, read Airway is Life, Dr. Dassani’s guide to sleep and airway health.