Diabetes and Obstructive Sleep Apnoea: Exploring the Bi-directional Link

Diabetes and obstructive sleep apnoea (OSA) are interconnected chronic conditions. The increasing prevalence of obesity drives the pathogenesis of these interrelated disorders. OSA, characterised by nocturnal hypoxia resulting from recurrent episodes of upper airway obstruction during sleep, is common in individuals with type 2 diabetes mellitus (T2DM). At the same time, T2DM increases the risk of OSA through mechanisms involving obesity, systemic inflammation, and autonomic dysfunction. OSA increases insulin resistance, impairs glucose tolerance, and worsens glycaemic control. Management strategies should involve early screening for OSA in individuals with T2DM and vice versa. Continuous positive airway pressure (CPAP) therapy improves insulin sensitivity and cardiovascular outcomes, though its impact on glycaemic control remains inconsistent. Emerging evidence suggests that newer anti-obesity medications may reduce OSA severity alongside improving metabolic parameters. Future research should focus on identifying the molecular pathways linking OSA and diabetes, evaluating long-term CPAP benefits, and optimising pharmacological approaches to improve outcomes in both conditions.