Sleep Apnea and Metabolic Syndrome

[rd1978]

When I met with my sleep DR yesterday, we got into a discussion about Metabolic Syndrome. It came up in conversation because while reading my medical history, she noted that my Internist (primary physician) had noted in my record that I was "pre-diabetic." My primary was not overly concerned since I had just one occurrence of an elevated A1C and it was back to normal at the time of my physical in January. Anyway, my sleep DR said that "pre-diabetic" is really a misnomer and that the correct term is really "metabolic syndrome."

I had heard of that before but had no idea what it meant, so she proceeded to explain it in layman's terms. I may not have captured all the details exactly, but here's the gist of it which many of you may find interesting (I sure did):

When we sleep, our body repairs itself. Think of it as a calm, relaxing state. We wake up in the morning refreshed and our blood pressure is typically at its lowest point of the day. But people like us with Sleep Apnea have a far different experience. She used the analogy of being choked to explain: If you're being choked and can't breathe (which is effectively what our brain senses during sleep apnea events), your body automatically goes into "fight or flight" mode. The brain's response is to immediately trigger hormones to give us the immediate energy and alertness to *save* ourselves. Adrenaline and cortisol are among those hormones (sorry, can't remember the other 2 or 3 she mentioned). Anyway, one of the results of this is the release of glycogen (sugars) from our muscles and liver for quick energy. The event, of course, passes very quickly and insulin is released to moderate the excess *sugar* in our bloodstream. Unfortunately, excess sugar is not returned to the muscles or liver but, rather, is stored as fat. And since fat is not a source of quick energy, when the next sleep apnea event occurs, more glycogen is released and the whole cycle repeats itself. Now, imagine this happening over and over again (in my case, hundreds of times a night). Over time, our brains come to realize these are *false alarms*. The fight or flight reaction continues every time but, apparently, we become desensitized to the continuous release of insulin, and this can result in Type 2 Diabetes (unlike Type 1 Diabetes, which is when our body doesn't produce enough insulin to metabolize the sugar in our bloodstream, Type 2 Diabetes is an overabundance of insulin).

Let me emphasize that I am neither a doctor nor a scientist, and my explanation of the process above is simply my best recollection of what my DR explained to me, but this certainly helps to understand how sleep apnea can lead to weight gain (I've gained 20 lbs in the last 10 months and I'm in excellent health and exercise 5-6 days a week). My DR also mentioned that folks with metabolic syndrome tend to have higher blood pressure in the morning than would otherwise be expected, and also they tend to have a much higher than normal craving for sweets -- especially in the morning.

Again, please don't take anything I've said as gospel. But if it piques your curiosity, there are numerous articles available on-line that address this subject.

[Scooter32]

My doctor has diagnosed me with metabolic syndrome. Thanks for a little more explanation.

[ckpearson]

Thanks for that explanation. I was diagnosed about a month ago with pre-diabetes and 9 days ago with severe sleep apnea. Have been using a CPAP for the past 9 days and started noticing 4 or 5 days ago that I no longer was craving sugar. That was a very welcome surprise feature of using the CPAP and finally sleeping again!

[Janknitz]

What a great explanation and bravo to the doctor for taking the time to explain it all to you! That doctor is a keeper, more so if he/she also explained how a high carbohydrate low fat diet makes metabolic syndrome worse.

[ddk]

Interesting. I had a blood test recently and was told a similar thing about my insulin levels. This would also explain why I get night sweats. The rise in adrenalin and cortisol could be increasing metabolism and body temperature?

[copygirl]

This makes a lot of sense. I have severe insulin resistance (polycystic ovary syndrome) and it's been the worst during the past few years, when my sleep apnea started.