Obstructive sleep apnea: an unexpected cause of insulin resistance and diabetes

Endocrinol Metab Clin North Am. 2014 Mar;43(1):187-204. doi: 10.1016/j.ecl.2013.09.002. Epub 2013 Dec 8.


Obstructive sleep apnea (OSA) is prevalent with type 2 diabetes. Conversely, nondiabetic patients with OSA are at increased risk of developing insulin resistance and diabetes. These disorders independently contribute to increased cardiovascular and cerebrovascular morbidity and mortality. The pathophysiology of OSA may help explain these associations. Evidence demonstrates that treatment of OSA with continuous positive airway pressure may lead to improvement in insulin sensitivity, hemoglobin A1c, systemic hypertension, and other components of the metabolic syndrome. Recognizing and treating OSA in patients with insulin resistance or diabetes ameliorates OSA-related symptoms and improves cardiometabolic risk.

Keywords: CPAP; Cardiometabolic risk; Diabetes; Insulin resistance; Metabolic syndrome; OSA; Obstructive sleep apnea.

Publication types

  • Review

MeSH terms

  • Comorbidity*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / therapy
  • Humans
  • Insulin Resistance / physiology*
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / metabolism*
  • Sleep Apnea, Obstructive / therapy