Insulin resistance and obstructive sleep apnea: is increased sympathetic stimulation the link?
The science of sleep is in early stages of development, and the biochemical consequences of obstructive sleep apnea (OSA) are slowly being identified. Only recently have investigators begun to identify the commonalities and interaction between OSA and insulin resistance, the underlying pathology of type 2 diabetes. Obesity and increasing age play important parts in the natural history of both conditions, which frequently coexist. The purpose of this article is, first, to examine the extent and strength of studies that have investigated the association between OSA and increased insulin resistance or type 2 diabetes and, second, to propose a model that explains the association and cyclical interaction between OSA, obesity, and insulin resistance.
Chasens
Eileen R
ER
School of Nursing, Center for Sleep and Respiratory Neurobiology, School of Medicine, University of Pennsylvania, 2024 NEB, 420 Guardian Drive, Philadelphia, PA 19104, USA. echasens@nursing.upenn.edu
Weaver
Terri E
TE
Umlauf
Mary Grace
MG
D017677:Age Distribution; D000367:Age Factors; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D018450:Disease Progression; D014943:Global Health; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D017286:Polysomnography; D011175:Positive-Pressure Respiration; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism* / Q000628:therapy; D014481:United States / Q000453:epidemiology