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Jim,

I think that your observations about the inevitability of overnight blood sugar rise may be more applicable to diabetics on insulin than those whose illness can be handled my less drastic means. Even if mine is rising overnight, my figures so far show that that rise is very significantly less after nights without CPAP.

The scenario you describe of distress in the night due to waking without CPAP being responsible for lower blood glucose numbers without CPAP doesn't seem to fit what I've read or heard: Stress raises cortisol and adrenaline which in turn raise blood sugar to put more of it into the blood stream to use of the muscles in 'fight or flight.'

(While I don't recall all the details, I've read there are two routes to higher morning readings in diabetics: One involves those who take insulin and has to do with overcompensation...factors I didn't pay much attention to because I don't take insulin. And the other involves sleeping badly -> stress -> adrenaline/cortisol -> blood glucose increase.)

FOR ME it may be that it is more stressful for me to sleep with CPAP than without. But I doubt that it is true of those who have much worse OSA.

And there could quite an individual factor in how we react to the abnormal inhalation/exhalation ratios produced by CPAP even at very low pressure settings.

Even after 1.5 years on CPAP and being in all other ways comfortable with it, I still feel stressed by the I/E ratio problem, still wake up in an anxious state every morning and have to calm myself down with a better breathing ratio. If most other people were similarly aware of the effect of bad I/E ratios on CPAP, I probably wouldn't be met with incredulity every time I post about it here!

Grace

I was thinking the I/E ratio was set by the brain, With my APAP, I never had to fight the machine. When I first goto bed I breath too deeply, but that's just a mind thing, with time the med's, that cause it soon kick out. (Puffer)

I am sure different levels of diabetes give us all different results. I was on pills for over 10 years, and basically was out of control. But due to my job it was necessary to ignore my health and take care of business. Now that's over and I've paid the price big time. For me, the stress brought on by poor cpap treatment would release more adrenaline and cause my insulin to burn more fuel. One thing for sure our bodies react different, they don't even react the same day to day. Good luck with your health and pleasant dreams. Jim

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My fasting glucose values have also been normal for several years. Using cpap for 6 months they have been increasing. 2 hours after a meal they are much better, normal. Either a new comorbidity or cpap has something to do with it. Cpap. ha S improved the quality of my life so I will work on my diet and exercise more.

Good for you... but you're responding to a 2007 post.

jeni wrote:My fasting glucose values have also been normal for several years. Using cpap for 6 months they have been increasing. 2 hours after a meal they are much better, normal. Either a new comorbidity or cpap has something to do with it. Cpap. ha S improved the quality of my life so I will work on my diet and exercise more.

Hi Jeni,

This is my favorite site as far as metabolic issues:

https://lowcarbrn.wordpress.com/

As an FYI, you can have normal blood sugar for years and then it can soar if you have trouble with insulin resistance. Cpap had nothing to do with it.

49er

There is a known connection between Sleep Apnea and diabetes. Thus, it's possible that years of untreated Sleep Apnea are catching up to you, rather than CPAP being the culprit.

Quite often, patients seek a sleep specialist only when the symptoms reach a critical mass, so that could explain why the timing seems coincidental in so many patients.

In any case, I would seek out a diabetes specialist to see what (s)he thinks.

Cpap has helped me do what I need to control my blood sugar.
(Walking, preparing nutritious food, etc.)

There's a well-known effect where dehydration causes blood sugar to spike. My blood sugar has been slightly elevated, or just on the high side of normal, for the last 7-8 years. The tests have all been first thing in the morning, at the endocrinologist's office, after I've gotten up and driven an hour to get to the appointment. I have to fight dehydration every time otherwise it's almost impossible for them to get blood out. I've been on APAP for 2 years, and lost 125 lbs over the last 21 months. I was expecting my blood sugar to go down with the weight loss, but it hasn't. Last time I was at the endo we tested my A1C -- which was rock-solid normal. So the conclusion is that the (slightly) elevated glucose is just a transient effect of the dehydration, and the test circumstances are that I am always dehydrated so always catching it at just that point.

But, anyway, morning dehydration is also a pretty strong sign of untreated apnea -- when you are getting up to pee large amounts every hour all night you run out by morning! So, if anything, treating the apnea should help that some.

I'm also not quite sure what the OP was talking about with I/E ratios and the machine. Maybe machines worked differently 9 years ago? I tried that exhalation relief thingy on my machine for about 5 minutes and turned it off. Yikes! With the mask throbbing on my face at every breath there is NO WAY I'm getting any sleep! Also, once the mask is on for a minute or two I can't feel the air. If the mask is sealed and it's silent, I have to hold my hand in front of it to figure out whether it's on or not! On more than one occasion I've woken up thinking there was a power failure or something because I'm sure the machine is off. I'll click the dial over and it will say that the pressure is not only on, but at 14, 15, 17... The closest thing to anxiety is me worrying that the machine is off when it is actually on.

You're confusing a dry mouth caused by air passing across/through it and dehydration, which is a system wide need for water in a big way... the two are not comparable.

I could see your body being stressed with the with pressure set 4-8. @ under 6 my mask will not vent all of the expelled CO2 from each breath. If you're up for the experiment, I would bump the pressure range to 7-12 and test again. I haven't seen any sleepyhead data, to see where your pressures run each night but that would be good to check too.

I have the same issue. My endo Dr. said the clap affects all parts of your body and can cause sugar levels to rise.

poedunk65 wrote:I have the same issue. My endo Dr. said the clap affects all parts of your body and can cause sugar levels to rise.

if you've got the clap, you really should get it treated.

poedunk65 wrote:I have the same issue. My endo Dr. said the clap affects all parts of your body and can cause sugar levels to rise.

The CLAP??? Are you talking about the venereal disease "Gonorrhea" or did you misspell CPAP?
Continuous Positive Air Pressure.

If you're really talking about the clap "Gonorrhea"........you need to do some reading and follow your doctors orders.

https://en.wikipedia.org/wiki/Gonorrhea


Den

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poedunk65 wrote:I have the same issue. My endo Dr. said the clap affects all parts of your body and can cause sugar levels to rise.

Besides your obvious misspelling, CPAP does NOT cause the blood sugar levels to rise. When a doctor (or anyone else, comes out with something preposterous like that, you need to ask him or her to SHOW YOU THE SCIENCE.

A nice summary of studies here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334388/

[/There is a strong association between OSA and diabetes mellitus. A multitude of pathophysiological perturbations have been demonstrated both in vitro and in vivo that demonstrate a close interrelationship, including inflammatory mediators of oxidative stress, as well as leptin resistance and hypothalamo-pituitary axis dysregulation. These effects are mediated secondary to both the effect of intermittent hypoxia as well as sleep fragmentation. Treatment with nightly CPAP leads to a resolution of both these behaviors and has been shown to be effective, not only in resolving daytime sleepiness, but also improving cardiovascular mortality. The data on the impact, if any, and its magnitude on glycemic control are neither convincing nor clear. The few randomized trials that have explored this impact have had mixed results, moreover confounded by the influence of morbid obesity as well as lack of optimal CPAP compliance. Future research is needed to clarify both the downstream mechanisms that stem from sleep fragmentation and the oxidative stress of intermittent hypoxia, as well as the impact of complete resolution of OSA with adequate CPAP compliance (adequately powered and randomized controlled design) on the metabolic profile of patients with OSA and diabetes mellitus in both obese and non-obese cohorts.quote]

Janknitz wrote:

poedunk65 wrote:I have the same issue. My endo Dr. said the clap affects all parts of your body and can cause sugar levels to rise.

Besides your obvious misspelling, CPAP does NOT cause the blood sugar levels to rise. When a doctor (or anyone else, comes out with something preposterous like that, you need to ask him or her to SHOW YOU THE SCIENCE.

A nice summary of studies here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334388/

[/There is a strong association between OSA and diabetes mellitus. A multitude of pathophysiological perturbations have been demonstrated both in vitro and in vivo that demonstrate a close interrelationship, including inflammatory mediators of oxidative stress, as well as leptin resistance and hypothalamo-pituitary axis dysregulation. These effects are mediated secondary to both the effect of intermittent hypoxia as well as sleep fragmentation. Treatment with nightly CPAP leads to a resolution of both these behaviors and has been shown to be effective, not only in resolving daytime sleepiness, but also improving cardiovascular mortality. The data on the impact, if any, and its magnitude on glycemic control are neither convincing nor clear. The few randomized trials that have explored this impact have had mixed results, moreover confounded by the influence of morbid obesity as well as lack of optimal CPAP compliance. Future research is needed to clarify both the downstream mechanisms that stem from sleep fragmentation and the oxidative stress of intermittent hypoxia, as well as the impact of complete resolution of OSA with adequate CPAP compliance (adequately powered and randomized controlled design) on the metabolic profile of patients with OSA and diabetes mellitus in both obese and non-obese cohorts.quote]

+ 1, XPAP may make you feel better, so you can make choices, that can reduce the level of your diabetes.

Also NON use of XPAP, when needed, results is the release of adrenaline, that gives you the fight or flight reaction, which burns more sugar faster, making your blood sugar go lower (Good), but can also bring on Strokes, and or Heart Attacks and other Organ Damage. (Not So Good).... Jim