MON-526 Should We Screen for Obstructive Sleep Apnea in Men with Type 2 Diabetes?

Abstract Disclosure: E. Mignone: None. A. Vincent: None. S. Appleton: None. R. Adams: None. G.A. Wittert: None. Background: Obstructive sleep apnoea (OSA) is characterized by recurrent episodes of hypoxaemia due to upper airway obstruction during sleep. The reported prevalence of OSA in patients with type 2 diabetes (T2D) ranges from 23-86%. When co-existing, there is an association with poor glycaemic control and increased microvascular complications. Aim: To determine whether men with T2D should be routinely screened for OSA by polysomnography (PSG). Methods: Cross-sectional analysis of participants in the “sleep sub-study” (N=861) of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a prospective cohort study of community dwelling men in South Australia. The analysis set was 834 men aged 44-88 years. The severity of OSA, assessed by home PSG, was graded using the Apnea Hypopnea Index (AHI); mild 10-19, moderate 20-29 and severe ≥ 30. T2D was determined by medication use, fasting glucose or HbA1c. Associations with OSA and severe OSA were assessed by proportional odds (PPO) and logistic regressions adjusted for age and BMI. Mediation analysis used a linear outcome model for log AHI and a PPO mediation model for T2D. Results: There were 120, 195, and 519 men with T2D, pre- T2D and no T2D respectively. The mean BMI was 30.3, 28.9, and 28.2, for T2D, pre-T2D and no T2D groups respectively. The prevalence of moderate or severe OSA in men with T2D [95%CI] was 28.3% [20.5-37.3], compared to 29.7% [23.4-36.7] and 24.3% [20.6-28.2] with pre-T2D or no T2D respectively. Severe OSA prevalence was 17.5% [11.2-25.5], 15.9% [11.1-21.8] and 9.8% [7.4-12.7] in T2D, pre-T2D and no T2D respectively. Moderate or severe REM-OSA prevalence was 45.8% [36.7-55.2] with T2D, compared to 36.9% [30.1-44.1] with pre-T2D and 35.1% [31-39.3] with no diabetes. T2D was associated with OSA (p=0.004) and REM-OSA (p=0.02). Pre-T2D was not associated with OSA (p=0.08) nor REM-OSA (p=0.26). On multivariable analysis age (p=0.0002) and BMI (p<0.0001) but not T2D associated with OSA of any severity, and similar results for REM-OSA. T2D did not mediate the association between BMI and OSA (p=0.66). Conclusion: There is a higher risk of severe OSA and REM-OSA in men with T2D compared to those without T2D. This is not independently mediated by the presence of diabetes, and instead by age and BMI. Although not independently associated, OSA should be excluded by PSG in men with T2D given the high prevalence and implications for glycaemic control and complication risk. Presentation: Monday, July 14, 2025