Skip to main content

Diabetes and Sleep Disorders

  • Living reference work entry
  • Latest version View entry history
  • First Online:
Principles of Diabetes Mellitus
  • 232 Accesses

Abstract

Although the prevalence of both diabetes and sleep apnea coincides with the epidemic of obesity, current evidence suggests that the interconnections between diabetes and obstructive sleep apnea–hypopnea syndrome (OSA) are not simply due to their common risk factor of obesity. Physiologic derangements and mediators released during sleep as a result of OSA appear to lead to impaired glucose metabolism, increasing the likelihood of diabetes and impairing the efficacy of its treatment. In addition, the metabolic abnormalities of diabetes could worsen the severity of OSA or affect compensatory mechanisms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Hla KM, Young TB, Bidwell T, et al. Sleep apnea and hypertension. A population-based study. Ann Intern Med. 1994;120:382–8.

    Article  CAS  PubMed  Google Scholar 

  2. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ. 2000;320:479–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA. 2000;283:1829–36.

    Article  CAS  PubMed  Google Scholar 

  4. Young T, Peppard P, Palta M, et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med. 1997;157:1746–52.

    Article  CAS  PubMed  Google Scholar 

  5. Grote L, Ploch T, Heitmann J, et al. Sleep-related breathing disorder is an independent risk factor for systemic hypertension. Am J Respir Crit Care Med. 1999;160:1875–82.

    Article  CAS  PubMed  Google Scholar 

  6. Bixler EO, Vgontzas AN, Lin HM, et al. Association of hypertension and sleep-disordered breathing. Arch Intern Med. 2000;160:2289–95.

    Article  CAS  PubMed  Google Scholar 

  7. Bradley TD, Rutherford R, Grossman RF, et al. Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis. 1985;131:835–9.

    CAS  PubMed  Google Scholar 

  8. Sajkov D, Cowie RJ, Thornton AT, et al. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 1994;149:416–22.

    Article  CAS  PubMed  Google Scholar 

  9. Guidry UC, Mendes LA, Evans JC, et al. Echocardiographic features of the right heart in sleep-disordered breathing: the Framingham Heart Study. Am J Respir Crit Care Med. 2001;164:933–8.

    Article  CAS  PubMed  Google Scholar 

  10. Arias MA, Garcia-Rio F, Alonso-Fernandez A, et al. Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure: a randomized, controlled cross-over study. Eur Heart J. 2006;27:1106–13.

    Article  PubMed  Google Scholar 

  11. Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53.

    Article  PubMed  Google Scholar 

  12. Peker Y, Carlson J, Hedner J. Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Eur Respir J. 2006;28:596–602.

    Article  CAS  PubMed  Google Scholar 

  13. Yumino D, Tsurumi Y, Takagi A, et al. Impact of obstructive sleep apnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome. Am J Cardiol. 2007;99:26–30.

    Article  PubMed  Google Scholar 

  14. Gami AS, Rader S, Svatikova A, et al. Familial premature coronary artery disease mortality and obstructive sleep apnea. Chest. 2007;131:118–21.

    Article  PubMed  Google Scholar 

  15. Arzt M, Young T, Finn L, et al. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med. 2005;172:1447–51.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Yaggi HK, Concato J, Kernan WN, et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353:2034–41.

    Article  CAS  PubMed  Google Scholar 

  17. Mehra R, Benjamin EJ, Shahar E, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: the Sleep Heart Health Study. Am J Respir Crit Care Med. 2006;173:910–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Garrigue S, Pepin JL, Defaye P, et al. High prevalence of sleep apnea syndrome in patients with long-term pacing: the European Multicenter Polysomnographic Study. Circulation. 2007;115:1703–9.

    Article  PubMed  Google Scholar 

  19. Alonso-Fernandez A, Garcia-Rio F, Racionero MA, et al. Cardiac rhythm disturbances and ST-segment depression episodes in patients with obstructive sleep apnea-hypopnea syndrome and its mechanisms. Chest. 2005;127:15–22.

    Article  PubMed  Google Scholar 

  20. Zwillich C, Devlin T, White D, et al. Bradycardia during sleep apnea. Characteristics and mechanism. J Clin Invest. 1982;69:1286–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Miller WP. Cardiac arrhythmias and conduction disturbances in the sleep apnea syndrome. Prevalence and significance. Am J Med. 1982;73:317–21.

    Article  CAS  PubMed  Google Scholar 

  22. Tilkian AG, Guilleminault C, Schroeder JS, et al. Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med. 1977;63:348–58.

    Article  CAS  PubMed  Google Scholar 

  23. Walsh J. Sleep disorders medicine. Rochester: Association of Professional Sleep Societies; 1986.

    Google Scholar 

  24. Holland JV, Dement WC, Raynal DM. Polysomnography: a response to a need for improved communication. In: Presented at the 14th annual meeting of the association for the psychophysiological study of sleep. Jackson Hole: Association for the psychophysiological study of sleep; 1974. p. 121.

    Google Scholar 

  25. Iber C, Ancoli-Israel S, Chesson AL, et al. The AASM manual for the scoring of sleep and associated events. West Chester: American Academy of Sleep Medicine; 2007.

    Google Scholar 

  26. Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med. 1996;154:279–89.

    Article  CAS  PubMed  Google Scholar 

  27. Hiestand DM, Britz P, Goldman M, et al. Prevalence of symptoms and risk of sleep apnea in the US population: results from the national sleep foundation sleep in America 2005 poll. Chest. 2006;130:780–6.

    Article  PubMed  Google Scholar 

  28. Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA. 2004;291:2013–6.

    Article  CAS  PubMed  Google Scholar 

  29. Palmer LJ, Redline S. Genomic approaches to understanding obstructive sleep apnea. Respir Physiol Neurobiol. 2003;135:187–205.

    Article  CAS  PubMed  Google Scholar 

  30. Strohl KP, Cherniak NS, Gothe B. Physiologic basis of therapy for sleep apnea. Am Rev Respir Dis. 1986;134:791.

    CAS  PubMed  Google Scholar 

  31. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    Article  CAS  PubMed  Google Scholar 

  32. Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J. 1990;3:509–14.

    CAS  PubMed  Google Scholar 

  33. Browman CP, Sampson MG, Yolles SF, et al. Obstructive sleep apnea and body weight. Chest. 1984;85:435–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Smith PL, Gold AR, Meyers DA, et al. Weight loss in mildly to moderately obese patients with obstructive sleep apnea. Ann Intern Med. 1985;103:p850–5.

    Article  Google Scholar 

  35. Issa FG, Sullivan CE. Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry. 1982;45:353–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Chervin RD, Theut S, Bassetti C, et al. Compliance with nasal CPAP can be improved by simple interventions. Sleep. 1997;20:284–9.

    Article  CAS  PubMed  Google Scholar 

  37. Pepin JL, Krieger J, Rodenstein D, et al. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients. Am J Respir Crit Care Med. 1999;160:1124–9.

    Article  CAS  PubMed  Google Scholar 

  38. Aloia MS, Di Dio L, Ilniczky N, et al. Improving compliance with nasal CPAP and vigilance in older adults with OAHS. Sleep Breath. 2001;5:13–21.

    Article  CAS  PubMed  Google Scholar 

  39. He J, Kryger MH, Zorick FJ, et al. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988;94:9–14.

    Article  CAS  PubMed  Google Scholar 

  40. Campos-Rodriguez F, Pena-Grinan N, Reyes-Nunez N, et al. Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest. 2005;128:624–33.

    Article  PubMed  Google Scholar 

  41. Bahammam A, Delaive K, Ronald J, et al. Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep. 1999;22:740–7.

    Article  CAS  PubMed  Google Scholar 

  42. Kapur V, Blough DK, Sandblom RE, et al. The medical cost of undiagnosed sleep apnea. Sleep. 1999;22:749–55.

    Article  CAS  PubMed  Google Scholar 

  43. Giles TL, Lasserson TJ, Smith BJ, et al. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev. 2006;25(1):CD001106.

    Google Scholar 

  44. Patel SR, White DP, Malhotra A, et al. Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: results of a meta-analysis. Arch Intern Med. 2003;163:565–71.

    Article  PubMed  Google Scholar 

  45. Gotsopoulos H, Chen C, Qian J, et al. Oral appliance therapy improves symptoms in obstructive sleep apnea: a randomized, controlled trial. Am J Respir Crit Care Med. 2002;166:743–8.

    Article  PubMed  Google Scholar 

  46. Hoekema A, Stegenga B, De Bont LG. Efficacy and co-morbidity of oral appliances in the treatment of obstructive sleep apnea-hypopnea: a systematic review. Crit Rev Oral Biol Med. 2004;15:137–55.

    Article  CAS  PubMed  Google Scholar 

  47. Schwartz JR, Hirshkowitz M, Erman MK, et al. Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea: a 12-week, open-label study. Chest. 2003;124:2192–9.

    Article  CAS  PubMed  Google Scholar 

  48. Black JE, Hirshkowitz M. Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep. 2005;28:464–71.

    Article  PubMed  Google Scholar 

  49. Hirshkowitz M, Black JE, Wesnes K, et al. Adjunct armodafinil improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome. Respir Med. 2007;101:616–27.

    Article  CAS  PubMed  Google Scholar 

  50. Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta: US Department of Health and Human Services; 2014.

    Google Scholar 

  51. West SD, Nicoll DJ, Stradling JR. Prevalence of obstructive sleep apnoea in men with type 2 diabetes. Thorax. 2006;61:945–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Foster GD, Sanders MH, Millman R, et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009;32:1017–9.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Spath-Schwalbe E, Gofferje M, Kern W, et al. Sleep disruption alters nocturnal ACTH and cortisol secretory patterns. Biol Psychiatry. 1991;29:575–84.

    Article  CAS  PubMed  Google Scholar 

  54. Semple PD, Beastall GH, Watson WS, et al. Hypothalamic-pituitary dysfunction in respiratory hypoxia. Thorax. 1981;36:605–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Raff H, Roarty TP. Renin, ACTH and aldosterone during acute hypercapnia and hypoxia in conscious rats. Am J Physiol. 1988;254:R431–5.

    CAS  PubMed  Google Scholar 

  56. Raff H, Shinsako J, Keil LC, et al. Vasopressin, ACTH and corticosteroids during hypercapnia and graded hypoxia in dogs. Am J Physiol. 1983;244:E453–8.

    CAS  PubMed  Google Scholar 

  57. Shin MK, Han W, Bevans –Fonti S, et al. The effect of adrenal medullectomy on metabolic responses to chronic intermittent hypoxia. Respir Physiol Neurobiol. 2014;203:60–7.

    Article  PubMed  Google Scholar 

  58. Strohl KP, Novak RD, Singer W, et al. Insulin levels, blood pressure and sleep apnea. Sleep. 1994;17:614–8.

    Article  CAS  PubMed  Google Scholar 

  59. Ip MS, Lam B, Ng MM, et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med. 2002;165:670–6.

    Article  PubMed  Google Scholar 

  60. Vgontzas A, Legro RS, Bixler EO, et al. Polycystic Ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab. 2001;86:517–20.

    CAS  PubMed  Google Scholar 

  61. Vgontzas A, Papanicolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance and hypercytokinemia. J Clin Endocrinol Metab. 2000;85:1151–8.

    Article  CAS  PubMed  Google Scholar 

  62. Punjabi NM, Sorkin JD, Katzel LI, et al. Sleep disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med. 2002;165:677–82.

    Article  PubMed  Google Scholar 

  63. Saaresranta T, Polo O. Sleep-disordered breathing and hormones. Eur Respir J. 2003;22:161–72.

    Article  CAS  PubMed  Google Scholar 

  64. Gotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-α: direct role in obesity-linked insulin resistance. Science. 1993;259:87–91.

    Article  Google Scholar 

  65. DeCourten M, Zimmet P, Hodge A, et al. Hyperleptinaemia: the missing link in the metabolic syndrome? Diabet Med. 1997;14:200–8.

    Article  CAS  Google Scholar 

  66. 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;172:1590–5.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Rebrin K, Steil GM, Mittelman S, et al. Causal linkage between insulin suppression of lipolysis and suppression of liver glucose output. J Clin Invest. 1996;98:741–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Trayhurn P, Beattie JH. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc. 2001;60:329–39.

    Article  CAS  PubMed  Google Scholar 

  69. Speigel K, Tasali E, Penev P, et al. Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004;141:846–50.

    Article  Google Scholar 

  70. Cheng N, Cai W, Jiang M, et al. Effect of hypoxia on blood glucose hormones, and insulin receptor functions in newborn calves. Pediatr Res. 1997;41:852–6.

    Article  CAS  PubMed  Google Scholar 

  71. Raff H, Bruder ED, Jankowski BM. The effect of hypoxia on plasma leptin and insulin in newborn and juvenile rats. Endocrine. 1999;11:37–9.

    Article  CAS  PubMed  Google Scholar 

  72. Larsen JJ, Hansen JM, Olsen NV, et al. The effect of altitude hypoxia on glucose homeostasis in men. J Physiol. 1997;504:241–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Braun B, Rock PB, Zamudio S, et al. Women at altitude: short-term exposure to hypoxia and/or α1-adrenergic blockade reduces insulin sensitivity. J Appl Physiol. 2001;91:623–31.

    CAS  PubMed  Google Scholar 

  74. Hjalmarsen A, Aasebo U, Birkeland K, et al. Impaired glucose tolerance in patients with chronic hypoxic pulmonary disease. Diabetes Metab. 1996;22:37–42.

    CAS  PubMed  Google Scholar 

  75. Tijhonen M, Partinen M, Narvanen S. The severity of obstructive sleep apnoea is associated with insulin resistance. J Sleep Res. 1993;2:56–61.

    Article  Google Scholar 

  76. Veldhuis JD, Iranmanesh A. Physiological regulation of the human growth hormone (GH)-insulin-like growth factor type I (IGF-I) axis: predominant impact of age, obesity, gonadal function, and sleep. Sleep. 1996;19:S221–4.

    Article  CAS  PubMed  Google Scholar 

  77. Speigel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435–9.

    Article  Google Scholar 

  78. Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Article  CAS  PubMed  Google Scholar 

  79. Mondini S, Guilleminault C. Abnormal breathing patterns during sleep in diabetes. Ann Neurol. 1985;17:391–5.

    Article  CAS  PubMed  Google Scholar 

  80. Katsumata K, Okada T, Miyao M, et al. High incidence of sleep apnea syndrome in a male diabetic population. Diabetes Res Clin Pract. 1991;13:45–51.

    Article  CAS  PubMed  Google Scholar 

  81. Grunstein RR, Ho KY, Sullivan CE. Sleep apnea in acromegaly. Ann Intern Med. 1991;115:527–32.

    Article  CAS  PubMed  Google Scholar 

  82. Catterall JR, Calverley PM, Ewing DJ, et al. Breathing, sleep, and diabetic autonomic neuropathy. Diabetes. 1984;33:1025–7.

    Article  CAS  PubMed  Google Scholar 

  83. Kendzerska T, Gershon AS, Hawker G, et al. Obstructive sleep apnea and incident diabetes. A historical cohort study. Am J Respir Crit Care Med. 2014;190:218–25.

    Article  PubMed  Google Scholar 

  84. Resnick H, Redline S, Shahar E, et al. Diabetes and sleep disturbances. Findings from the sleep heart health study. Diabetes Care. 2003;26:702–9.

    Article  PubMed  Google Scholar 

  85. Stoohs RA, Facchini F, Guilleminault C. Insulin resistance and sleep-disordered breathing in healthy humans. Am J Respir Crit Care Med. 1996;154:170–4.

    Article  CAS  PubMed  Google Scholar 

  86. Elmasry A, Janson C, Lindberg E, et al. The role of habitual snoring and obesity in the development of diabetes: a 10-year follow-up study in a male population. J Intern Med. 2000;248:13–20.

    Article  CAS  PubMed  Google Scholar 

  87. Al Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for type II diabetes mellitus: a prospective study. Am J Epidemiol. 2002;155:387–93.

    Article  PubMed  Google Scholar 

  88. Facchini F, Stoohs R, Harter R, et al. Sleep related glucose and insulin plasma concentrations in obese patients with obstructive sleep apnea before and after treatment with nasal CPAP [Abstract]. J Sleep Res. 1992;1 suppl 1:71.

    Google Scholar 

  89. Smurra M, Philip P, Taillard J, et al. CPAP treatment does not affect glucose-insulin metabolism in sleep apneic patients. Sleep Med. 2001;2:207–13.

    Article  CAS  PubMed  Google Scholar 

  90. Brooks B, Cistulli P, Borkman M, et al. Obstructive sleep apnea in obese on insulin-dependent diabetic patients: effect of continuous positive airway pressure treatment on insulin responsiveness. J Clin Endocrinol Metab. 1994;79:1681–5.

    CAS  PubMed  Google Scholar 

  91. Harsch IA, Pour Schahin S, Radespiel-Tröger M, et al. Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 2004;169:156–62.

    Article  PubMed  Google Scholar 

  92. Harsch IA, Pour Schahin S, Brückner K, et al. The effect of continuous positive airway pressure treatment on insulin sensitivity in patients with obstructive sleep apnoea syndrome and type 2 diabetes. Respiration. 2004;71:252–9.

    Article  PubMed  Google Scholar 

  93. Babu AR, Herdegen J, Fogelfeld L, et al. Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med. 2005;165:447–52.

    Article  PubMed  Google Scholar 

  94. Barceló A, Barbé F, de la Peña M, et al. Insulin resistance and daytime sleepiness in patients with sleep apnoea. Thorax. 2008;63:946–50.

    Article  PubMed  Google Scholar 

  95. Coughlin SR, Mawdsley L, Mugarza JA, et al. Cardiovascular and metabolic effects of CPAP in obese males with OSA. Eur Respir J. 2007;29:720–7.

    Article  CAS  PubMed  Google Scholar 

  96. Weinstock TG, Wang X, Rueschman M, et al. A controlled trial of CPAP therapy on metabolic control in individuals with impaired glucose tolerance and sleep apnea. Sleep. 2012;35:617–25B.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Yang D, et al. Effects of continuous positive airway pressure on glycemic control and insulin resistance in patients with obstructive sleep apnea: a meta-analysis. Sleep Breath. 2013;17(1):33–8.

    Article  PubMed  Google Scholar 

  98. Yang D, Liu Z, Yang H. The impact of effective continuous positive airway pressure on homeostasis model assessment insulin resistance in non-diabetic patients with moderate to severe obstructive sleep apnea. Diabetes Metab Res Rev. 2012;28(6):499–504.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This revision to Diabetes and Sleep Disorders would not have been possible if not for the excellent initial chapter authored by Drs. Abhijith Hegde and Steve H. Salzman.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steve H. Salzman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Chawla, S., Salzman, S. (2017). Diabetes and Sleep Disorders. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Cham. https://doi.org/10.1007/978-3-319-20797-1_37-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20797-1_37-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20797-1

  • Online ISBN: 978-3-319-20797-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Diabetes and Sleep Disorders
    Published:
    16 February 2017

    DOI: https://doi.org/10.1007/978-3-319-20797-1_37-2

  2. Original

    Diabetes and Sleep Disorders
    Published:
    19 February 2016

    DOI: https://doi.org/10.1007/978-3-319-20797-1_37-1