title: Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro- and macrovascular complications.
abstract: OBJECTIVE
  Few reports have assessed the relationship between Type 1 diabetes and sleep disorders. The purposes of our study were to determine the prevalence of obstructive sleep apnoea in Type 1 diabetes and to compare the clinical profile of people with Type 1 diabetes with or without obstructive sleep apnoea.
  
  
  METHODS
  In this cross sectional study of 67 consecutive people with Type 1 diabetes, we performed polysomnography as part of their yearly check-ups.
  
  
  RESULTS
  In our cohort, with a mean BMI of 25.8 ± 4.7 kg/m(2), the prevalence of obstructive sleep apnoea [apnoea-hypopnoea index (AHI) > 10/h] was 46%. Severe obstructive sleep apnoea (AHI ≥ 30/h) was present in 19% of the patients. We found no significant differences in age, sex, body mass index, HbA1c or Epworth sleepiness scale score between people with or without obstructive sleep apnoea. People with obstructive sleep apnoea had a longer course of diabetes mellitus (P < 0.01) and a higher prevalence of retinopathy (P < 0.01), neuropathy (P = 0.05), cardiovascular disease (P < 0.01) and hypertension (P < 0.01). The occurrence of macrovascular complications was independently associated with the presence of OSA [odds ratio (OR) 8.28; 95% confidence interval (CI), 1.56-43.97; P = 0.013] and the duration of diabetes (OR 1.08; 95% CI, 1.02-1.15; P = 0.01). Moreover, retinopathy was independently associated with OSA (OR 4.54; 95% CI, 1.09-18.82; P = 0.04) and the duration of diabetes (OR 1.09; 95% CI, 1.04-1.15; P = 0.001).
  
  
  CONCLUSIONS
  The prevalence of obstructive sleep apnoea was high in people with Type 1 diabetes. Obstructive sleep apnoea was independently associated with macrovascular complications and retinopathy. Obesity and excessive daytime sleepiness were uncommon in this population.
authors.affiliation: Department of Pneumology, Hôpitaux universitaires de Strasbourg, Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Manin
authors.forename: A
authors.initials: A
authors.lastname: Pons
authors.forename: P
authors.initials: P
authors.lastname: Baltzinger
authors.forename: F
authors.initials: F
authors.lastname: Moreau
authors.forename: C
authors.initials: C
authors.lastname: Iamandi
authors.forename: J M
authors.initials: JM
authors.lastname: Wilhelm
authors.forename: P
authors.initials: P
authors.lastname: Lenoble
authors.forename: L
authors.initials: L
authors.lastname: Kessler
authors.forename: R
authors.initials: R
authors.lastname: Kessler
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000209:etiology; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000209:etiology