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

99 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

Funding Information:
This study was supported by the National Heart, Lung, and Blood Institute contracts ( HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HHSN268201100008C , HHSN268201100009C , HHSN268201100010C , HHSN268201100011C , and HHSN268201100012C ), and the cooperative agreements U01HL53934 ( University of Minnesota ) and U01HL64360 ( Johns Hopkins University ). P.L. was supported by the National Heart, Lung and Blood Institute ( R21 HL121412 ), E.S. by the National Institute of Diabetes and Digestive and Kidney Diseases ( R01 DK089174 ), and N.M.P. by the National Heart, Lung and Blood Institute ( R01 HL075078 ). Reagents for the high sensitivity C-reactive protein assays were donated by the Roche Diagnostics Corporation.

Publisher Copyright:
© 2016 Elsevier B.V.


  • Diabetes
  • Epidemiology
  • Obesity
  • Obstructive sleep apnea


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