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Diabetes und Schlafapnoe

Diabetes and sleep apnea

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

„Der Schlaf ist doch die köstlichste Erfindung.“ Heinrich Heine (1797–1856)

Zusammenfassung

Hintergrund

Die obstruktive Schlafapnoe (OSA) stellt eine häufige Komorbidität bei Patienten mit Diabetes mellitus Typ 2 mit gegenseitiger Wechselwirkung dar.

Obstruktive Schlafapnoe und Typ-2-Diabetes

Schlafbezogene Störungen der Atmung können über wiederkehrende nächtliche Sauerstoffentsättigungen, Schlafunterbrechungen, sympathische Nervenaktivierung sowie weitere pathophysiologische Mechanismen zu einer gestörten Glukoseregulation führen. Daher ist bei bestehender OSA auch das Risiko für die Neuentstehung einer diabetischen Stoffwechsellage erhöht.

Therapiemaßnahmen

Obwohl eine unabhängige Assoziation beider Erkrankungen nachgewiesen wurde, fanden sich in Studien widerstreitende Effekte einer nächtlichen Atemwegsüberdrucktherapie auf den Glukosestoffwechsel. Neben einer ausreichenden Adhärenz bezüglich der nächtlichen Maskenbehandlung sollten auch flankierende Maßnahmen im Sinne einer multimodalen Therapie Beachtung finden. Hier könnten telemedizinische Anwendungen zu einer Verbesserung des Patientenmanagements beitragen.

Jüngste Studienresultate

In jüngster Zeit mehren sich Hinweise auf einen Zusammenhang von OSA und Diabetes mellitus Typ 1 bzw. Gestationsdiabetes.

Abstract

Background

Obstructive sleep apnea (OSA) is a frequent comorbidity in patients with type 2 diabetes.

Obstructive sleep apnea and type 2 diabetes

Sleep disordered breathing can lead to a dysregulation of glycemic metabolism via repetitive oxygen desaturations, sleep fragmentation, sympathetic nerve activation and other pathophysiological links. Thus, OSA can increase the risk of incident type 2 diabetes.

Therapeutic measures

Although an independent link between OSA and type 2 diabetes has been shown, there are conflicting data about the effects of continuous positive airway pressure (CPAP) therapy on glucose metabolism in OSA. In addition to sufficient CPAP adherence, other factors should be monitored following a multi-modal treatment strategy. Telemedical solutions could improve patient management. Recent data also show links between OSA and type 1 diabetes and gestational diabetes.

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Authors and Affiliations

  1. Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    C. Schöbel

  2. Interdisziplinäres Schlafmedizinisches Zentrum, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    C. Schöbel

  3. Klinik für Schlafmedizin GmbH, Medical Center Düsseldorf – Grand Arc, Düsseldorf, Deutschland

    H. Grüger & G. Schrörs

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  1. C. Schöbel
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Correspondence to C. Schöbel.

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Interessenkonflikt

C. Schöbel gibt folgende mögliche Interessenkonflikte an: Forschungsförderung und Vortragshonorare von ResMed, Philips Respironics, LivaNova, Berlin-Chemie, Novartis. H. Grüger gibt folgende mögliche Interessenkonflikte an: Forschungsförderung und Vortragshonorare von ResMed. G. Schrörs gibt an, dass kein Interessenkonflikt besteht.

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Schöbel, C., Grüger, H. & Schrörs, G. Diabetes und Schlafapnoe. Diabetologe 14, 18–26 (2018). https://doi.org/10.1007/s11428-018-0303-5

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