The aim of this study, conducted in 52 centres in France, was to determine the prevalence of obstructive sleep apnoea (OSA) in adults with type 1 diabetes. A total of 769 people, all treated with insulin pumps volunteered to participate during at-home insulin pump follow-up visits between 2016 and 2020. OSA was diagnosed using overnight oximetry and defined as mild-to-moderate (oxygen desaturation index [ODI] of 15–29 per hour) or severe (ODI ≥30 per hour).
Of the 769 participants, 12.4% had mild-to-moderate OSA and 3.4% had severe OSA. In multivariate analysis, age, sex, BMI and hypertension were all associated with OSA. After adjustment for age, sex and BMI, the presence of severe OSA was significantly associated with cardiovascular disease (odds ratio 3.96 compared with no OSA), and mild-to-moderate OSA was associated with retinopathy (odds ratio 2.09). HbA1c was not associated with OSA.
OSA was not associated with daytime sleepiness, fatigue or depression, suggesting that these symptoms would not be useful for predicting OSA in people with type 1 diabetes.
The authors acknowledge the limitations of the homogeneous study population of insulin pump users. Nonetheless, the study suggests that OSA is common in people with type 1 diabetes and warrants investigation, especially given its association with macro- and microvascular diabetes complications.
Vinod Patel highlights the growing evidence base that lifestyle interventions are effective, and encourages persistence even though they can be difficult.
25 May 2023