Diabetes Self-Management Blog

Sometimes, you just gotta laugh. I recently suffered through a sleep study. One of the instructions I was given when the place called the day before was to bring my evening medicines. In the spirit of full disclosure, I said, “that includes IV antibiotics, by the way.”

“We don’t have any nurses here,” was the response.

“That’s OK. I do it myself,” I said.

There was a pause from the other end of the phone line. Followed by a tentative, “Does your doctor know that?”

Anyway, I don’t know why they call it a “sleep” study. Normally, I can fall asleep any time in any place. That night? No way.

There probably were several reasons. For one, I had wires stuck onto my head, legs, chest, and chin, and above one eye and below the other. And I had two sets of prongs in my nose. Kind of like the oxygen things, but smaller. But there were two, remember? I think one was to see if you were breathing through your nose; the other to see if you were breathing through your mouth.

Lemme tell ya something: If you have two sets of prongs in your nose, you are going to be a mouth breather. Then your mouth gets dry and you’re sipping water all night, which causes you to have to go potty. A lot. And each time, you have to call somebody to unhook you from the motherboard. Then she has to come and hook you back up when you’re finished. By then, you’re good and awake.

On top of all that, I don’t generally sleep in a lot of clothing. OK, generally…none. That wouldn’t have been too kewl during a sleep study, when there’s a camera on you. So I had on a nightgown and my skivvies. Whenever I moved, my nightie went one way and my skivvies went the other way.

I think I got maybe two hours of sleep altogether.

In the course of things, however, I found out something new as my personal person, Suzanne, and I were chatting as she stuck wires to my head: “Did you know that people with diabetes are more likely to have sleep apnea?” she asked. (Or maybe it was vice-versa.)

No. No, I didn’t. I mean, I’d read articles and research about the association between lack of sleep and Type 2 diabetes, but hadn’t correlated that information with obstructive sleep apnea.

So I looked it up when I got home. And there it was, in report after report.

The most recent I found, from the March 1, 2010, issue of the American Journal of Respiratory and Critical Care Medicine, noted that obstructive sleep apnea “is a highly prevalent comorbidity of type 2 diabetes.” (In this case, “morbidity” is an illness or disease.) It’s also a predictor of glucose control, say the researchers from the University of Chicago’s Department of Medicine.

According to their research, 77% of the subjects (who had Type 2 diabetes) had obstructive sleep apnea, and a measurement of their HbA1cs showed increases ranging from a mean of 1.49% to 3.69%, depending on the severity of the obstructive sleep apnea. (A mean is the average of all the numbers.)

In other words, you can lower your HbA1c just by getting enough sleep. Make that quality sleep. The authors say the results are about the same as those accomplished by taking widely used glucose-lowering medicines.

Earlier research had shown that polycystic ovarian syndrome (PCOS) also is associated with obstructive sleep apnea. PCOS is associated with Type 2 diabetes, as well.

Lemme see…many of my relatives have (or had) Type 2 diabetes. Type 2 is associated with sleep apnea, which I have. It’s also associated with PCOS, which I have.

Did you ever get the idea you didn’t have a chance?

The solution to sleep apnea involves wearing a continuous positive airway pressure (CPAP) or Variable/Bilevel Positive Airway Pressure (BiPAP) apparatus while sleeping. In other words, you have all this stuff on you. I don’t like stuff on me. In fact, I tried CPAP about 10 years ago and got less sleep than when I didn’t have it on. So I stopped using it.

Now, however, I’m so tired and sleepy most of the time, I’m actually looking forward to getting back in gear (so to speak). Hopefully, I’ll be able to sleep long enough at the sleep clinic for them to adjust the oxygen pressure levels. I think that takes about four hours. Perhaps I should start practicing now.

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Comments
  1. I also had to suffer through one of those indignities called a “sleep study”. Never again! (At least, not until their technology enters the 21st century.)

    Microtransmitters are now small enough that there is no reason for you to be hooked up to anything with a wire to begin with. Not only do those wires restrict your motion, any time you turn, they get disconnected, so the attendant has to wake you and glue them back on. This happens about every twenty minutes.

    They do not allow you to follow your normal sleep/wake schedule. At the time, my normal schedule had me getting home at 8:30 in the evening and first needing dinner — there was no way I could be ready to fall asleep at 10! And then they say you can shower in the morning, but they rush you out the door before you can make even the roughest attempt at removing the electrode goo from your skin (not to mention it takes at least a week to get out of your hair — how about giving me one of those sensor caps instead?)

    They won’t let you sleep on your stomach. I can’t fall asleep in any other position. Therefore, no sleep.

    The room was way too cold and they refused to give me enough covers to not be awake shivering all night.

    With all these interruptions, there is no way one could get any sleep with which to make any real measurements. Everyone who goes through this sort of study comes out “having sleep apnea”. AFAIAC it is a “problem” invented to sell expensive equipment designed to choke you with the air tube and to suffocate you if you don’t have the device on a 100%-reliable, 8-hour-battery-life uninterruptible power supply (in case the power goes out during an overnight storm).

    And if there is such a confluence of Type 2 diabetes, obesity, and sleep apnea, why didn’t the sleep lab — which was in a hospital! — have sharps disposal units in the bedrooms, or at the very least, a sharps disposal container somewhere in the unit?

    AFAIAC, the whole set-up has the word “SCAM” written all over it.

    Posted by tmana |
  2. I was diagnosed with sleep apnea before I was diagnosed with Type II diabetes. My 1st sleep study was probably 8 or 9 years ago, and it was wonderful. Our hospital had a room much like a hotel room, and the stuff they used to attach the electrodes was wax. Yes, it was weird, but oddly enough I fell asleep within minutes after they got me hooked up and with the headgear on. Of course, I hadn’t been sleeping much at all before that.

    The first headgear I used was quite restrictive: think Man in the Mask. Now though, there are all different choices and I hardly know I have mine on. I use it anytime I lie down, and it barely makes any noise. If I sleep without it, I get dry mouth, sore throat and a headache. Of course, when you wear your headgear now, thanks to a little memory card, it’s impossible to lie to the doctor about how often you wear it, either. They just process the computer card!

    I need to lose weight now, which will undoubtedly help both my diabetes and my sleep apnea.

    Sometimes I wish I was Sleeping Beauty!

    Posted by Lisa Richardson |
  3. I’ve had three sleep studies (to keep things updated over the years), definitely have sleep apnea, and sleep every night with a Bi-pap machine.

    When I first got it, years ago, it went under the bed and stayed there for about three years. Then one night I decided to try actually using it to see if I would feel better in the AM. Suffice to say that I now use it ALL NIGHT every night and I wouldn’t be without it.

    You just gotta get used to it.

    Yes - I do feel better now than I did….

    Posted by Victor L. Halsig |
  4. I tend to agree! I felt as if I was being non-compliant by refusing to have a sleep apnea study when both my internist and heart doctor said I needed to have one — it would help my diabetes. Finally I consented. I didn’t sleep enough for them to make an accurate test and so had to go through the procedure a second time, this time with a sedative. Once I had the very expensive machine at home, I still couldn’t fall asleep with all the apparatus on me. Sleeping pills made me drowsy at work the next day. I finally gave it up. Now I fall asleep listening to audiobooks. So they also tell me that isn’t restful for my brain — but lying awake wanting to go to sleep is not restful for the brain either.

    Posted by Juanita Hazelton |
  5. I too have type 2 diabetes and underwent the sleep study test. I am one that does not have a problem sleeping - in any position. Just ask the wife. My test revealed at least 100 episodes of interrupted breathing due to the closing of my airway as I slept. This is nothing new to me as my father would come home from work, fall asleep in his recliner and wake up choking for air. And yet he never developed diabetes. The short story is they sold my health insurance company a $420 cpap machine for $1320 on top of the bill for the testing!! As if that weren’t enough, the cpap provider billed my insurance under 2 different company names and tried to collect double. I don’t know how much sleep I lost from tossing and turning due to the stess of dealing with these crooks, but I’m sure it was significant. I have become a wise consumer and found a website that gave me the directions I needed to adjust the machines pressure to a comfortable level that wouldn’t dry out my nasal passages and leave me with a case of windburn in my nose. I can now sleep thru the night and not wake in the middle of the night dryed out and gagging on sinus drainage. is now my go to website for information and supplies. Happy Dreams to all!!

    Posted by Bill Wildey |
  6. I also went through a sleep study. My CPAP appliance is in its case in the back of the closet.

    Too much discomfort, too much trouble.

    Since CPAP compliance is an issue, other ways of addressing obstructive sleep apnea have come up.

    One technology that has gotten attention involves devices called “mandibular advancement splints (MAS)”. They are appliances that you wear in your mouth when you sleep. They’re fitted by specially trained dentists and the results are very encouraging for mild to moderate obstructive sleep apnea (OSA).

    You may need a referral from your primary healthcare provider and a copy of your sleep study results. The devices may be covered by your health insurance, just like a CPAP device.

    The majority of patients get used to the device within a few days.

    You may drink water, have a conversation, walk about, watch TV and do most things you do at nighttime. It’s easy to maintain and travel is no problem (no additional baggage).

    You may find out more through a Google search.

    I’ve been doing research on this and I’m about to arrange to get one. I’ve met some apnea patients who use the dental appliances who are very happy with the results.

    It doesn’t hurt to ask. Anything for a good night’s sleep!

    Posted by bachilín |

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