Effekte des obstruktiven Schlafapnoesyndroms auf den Glukosestoffwechsel bei Menschen mit Diabetes

Das obstruktive Schlafapnoesyndrom (OSAS) gilt als die wichtigste Atemstörung im Schlaf. Definitionsgemäß liegt es vor, wenn eine obstruktive Schlafapnoe oder Hypopnoe mit dem Leitsymptom des OSAS, der exzessiven Tagesschläfrigkeit, zusammentrifft. Ein kompletter intermittierender Verschluss der oberen Luftwege wird als Apnoe beschrieben, eine partielle pharyngale Obstruktion mit Behinderung des inspirativen Luftflusses als Hypopnoe [1].

• Literatur

• 1 Becker HF, Classen M, Dierkesmann R, Heimpel H. Schlafbezogene Atmungsstörungen, Rationelle Diagnostik und Therapie in der Inneren Medizin. München, Jena: Urban & Fischer 2003; 6: 1-4
• 2 Young T, Palta M, Dempsey J. et al The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-1235 doi:10.1056/NEJM199304293281704
• 3 Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax 1991; 46: 85-90 doi:10.1136/thx.46.2.85
• 4 West SD, Nicoll DJ, Wallace TM. et al Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes. Thorax 2007; 62: 969-974 doi:10.1136/thx.2006.074351
• 5 Penzel T, Hajak G, Hoffmann L. et al Empfehlungen zur Durchführung und Auswertung polygraphischer Ableitungen im diagnostischen Schlaflabor. Z EEG-EMG 1993; 24: 65-70
• 6 Fischer J, Mayer G, Peter JH. et al Nicht-erholsamer Schlaf, Leitlinie “S2” der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). Somnologie 2001: 5 Suppl. 3
• 7 Ballester E, Badia JR, Hernández L. et al Evidence of the effectiveness of continous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999; 159: 495-501 doi:10.1164/ajrccm.159.2.9804061
• 8 Engleman HM, Kingshott RN, Wraith PK. et al Randomized placebo-controlled crossover trial of continous positive airway preassure for nightsleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999; 159: 461-467 doi:10.1164/ajrccm.159.2.9803121
• 9 Engleman HM, Martin SE, Kingshott RN. et al Randomised placebo controlled trial of daytime function after continuous positive airway pressure (CPAP) therapy for the sleep apnoea/hypopnoea syndrome. Thorax 1998; 53: 341-345 doi:10.1136/thx.53.5.341
• 10 Jenkinson C, Davies RJ, Mullins R. et al Comparison of therapeutic and subtherapeutic nasal continous positive airway pressure for obstructive sleep apnea: A randomized prospective parallel trial. Lancet 1999; 353: 2100-2105 doi:10.1016/S0140-6736(98)10532-9
• 11 Giles TL, Lasserson TJ, Smith BJ. et al Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 2006; 25: CD001106
• 12 Lim J, Lasserson TJ, Fleetham J. et al Oral appliances for obstructive sleep apnoea. Cochrane Database Syst Rev 2006; 1: CD004435
• 13 Smith I, Lasserson TJ, Wright J. Drug therapy for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 2006; 2: CD003002
• 14 Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am 2003; 32: 869-894 doi:10.1016/s0889-8529(03)00069-0
• 15 Durán J, Esnaola S, Rubio R. et al Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 2001; 163: 685-689 doi:10.1164/ajrccm.163.3.2005065
• 16 Bixler EO, Vgontzas AN, Ten Have T. et al Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 1998; 157: 144-148 doi:10.1164/ajrccm.157.1.9706079
• 17 Ancoli-Israel S, Kripke DF, Klauber MR. et al Sleep-disordered breathing in community-dwelling elderly. Sleep 1991; 14: 486-495 doi:10.1093/sleep/14.6.486
• 18 Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-143 doi:10.1513/pats.200709-155MG
• 19 Hung J, Whitford EG, Parsons RW. et al Association of sleep apnoea with myocardial infarction in men. Lancet 1990; 336: 261-264 doi:10.1016/0140-6736(90)91799-g
• 20 Shaw JE, Punjabi NM, Wilding JP. et al Sleep-disordered breathing and type 2 diabetes: A report from the International Diabetes Federation Taskforce on Epidemiology and Prevention. Diabetes Res Clin Pract 2008; 81: 2-12 doi:10.1016/j.diabres.2008.04.025
• 21 Reichmuth KJ, Austin D, Skatrud JB. et al Association of sleep apnea and type II diabetes: a population-based study. Am J Respir Crit Care Med 2005; 172: 1950-1955 doi:10.1164/rccm.200504-637OC
• 22 West SD, Nicoll DJ, Stradling JR. Prevalence of obstructive sleep apnoea in men with type 2 diabetes. Thorax 2006; 61: 945-950 doi:10.1136/thx.2005.057745
• 23 Foster GD, Sanders MH, Millman R. et al Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care 2009; 32: 1017-1019 doi:10.2337/dc08-1776
• 24 Resnick HE, Redline S, Shahar E. et al Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 2003; 26: 702-709 doi:10.2337/diacare.26.3.702
• 25 Tsigos C, Papanicolaou DA, Kyrou I. et al Dose-dependent effects of recombinant human interleukin-6 on glucose regulation. J Clin Endocrinol Metab 1997; 82: 4167-4170 doi:10.1210/jcem.82.12.4422
• 26 Pradhan AD, Manson JE, Rifai N. et al C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001; 286: 327-334 doi:10.1001/jama.286.3.327
• 27 Moller DE. Potential role of TNF-alpha in the pathogenesis of insulin resistance and type 2 diabetes. Trends Endocrinol Metab 2000; 11: 212-217 doi:10.1016/s1043-2760(00)00272-1
• 28 Spiegel K, Knutson K, Leproult R. et al Sleep loss: a novel risk factor for insulin resistence and type 2 diabetes. J Appl Physiol 2005; 99: 2008-2019 doi:10.1152/japplphysiol.00660.2005
• 29 Patruno V, Aiolfi S, Beghi G. et al Different efficacy of CPAP and AutoCPAP therapy in patients with sleep-apnea syndrome (OSAS). Rassegna di Patologia dell‘Apparato Respiratorio 2005; 20: 107-116
• 30 Kohler M, Ayers L, Pepperell JC. et al Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial. Thorax 2009; 64: 67-673
• 31 Comondore VR, Cheema R, Fox J. et al The impact of CPAP on cardiovascular biomarkers in minimally symptomatic patients with obstructive sleep apnea: a pilot feasibility randomized crossover trial. Lung 2009; 187: 17-22 doi:0.1007/s00408-008-9115-5
• 32 Pallayova M, Donic V, Tomori Z. Beneficial effects of severe sleep apnea therapy on nocturnal glucose control in persons with type 2 diabetes mellitus. Diabetes Res Clin Pract 2008; 81: 8-11 doi:10.1016/j.diabres.2008.03.012