Obstructive sleep apnea and incident type 2 diabetes

Mako Nagayoshi, Naresh M. Punjabi, Elizabeth Selvin, James S. Pankow, Eyal Shahar, Hiroyasu Iso, Aaron R. Folsom, Pamela L. Lutsey

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


Objectives To determine whether severity of obstructive sleep apnea is associated with incident diabetes in middle-aged and older adults. Methods A prospective analysis of 1453 non-diabetic participants of both the Atherosclerosis Risk in Communities Study and the Sleep Heart Health Study (mean age 63 years, 46% male) had in-home polysomnography (1996–1998) and was followed up for incident diabetes. Using the apnea–hypopnea index derived from home polysomnography, study participants were categorized as follows: <5.0 (normal), 5.0–14.9 (mild), 15.0–29.9 (moderate), and ≥30.0 events/h (severe). Incident diabetes was ascertained during annual follow-up telephone calls through 2013. Results During a median follow-up of 13 years, there were 285 incident diabetes cases among the 1453 participants. Participants with severe obstructive sleep apnea were at greater risk of incident diabetes compared to persons classified as normal after adjustment for confounders including body mass index and waist circumference (1.71 [1.08, 2.71]). The association between severe obstructive sleep apnea and incident diabetes was similar when analyses were restricted to obese individuals. Conclusions Severe obstructive sleep apnea was associated with greater risk of incident diabetes, independent of adiposity in a community-based sample. Healthcare professionals should be cognizant of the high prevalence of OSA in the general population and the potential link to incident diabetes.

Original languageEnglish (US)
Pages (from-to)156-161
Number of pages6
JournalSleep Medicine
StatePublished - Sep 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Elsevier B.V.


  • Diabetes
  • Epidemiology
  • Obesity
  • Obstructive sleep apnea


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