Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes

  1. Gary D. Foster, PHD1,
  2. Mark H. Sanders, MD2,
  3. Richard Millman, MD3,
  4. Gary Zammit, PHD4,
  5. Kelley E. Borradaile, PHD1,
  6. Anne B. Newman, MD2,
  7. Thomas A. Wadden, PHD5,
  8. David Kelley, MD2,
  9. Rena R. Wing, PHD3,
  10. F. Xavier Pi Sunyer, MD6,
  11. Valerie Darcey, MS5,
  12. Samuel T. Kuna, MD5 and
  13. for the Sleep AHEAD Research Group*
  1. 1Temple University, Philadelphia, Pennsylvania;
  2. 2University of Pittsburgh, Pittsburgh, Pennsylvania;
  3. 3Brown University, Providence, Rhode Island;
  4. 4Clinilabs, New York, New York;
  5. 5University of Pennsylvania, Philadelphia, Pennsylvania;
  6. 6Columbia University, New York, New York.
  1. Corresponding author: Gary D. Foster, gfoster{at}


OBJECTIVE To assess the risk factors for the presence and severity of obstructive sleep apnea (OSA) among obese patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS Unattended polysomnography was performed in 306 participants.

RESULTS Over 86% of participants had OSA with an apnea-hypopnea index (AHI) ≥5 events/h. The mean AHI was 20.5 ± 16.8 events/h. A total of 30.5% of the participants had moderate OSA (15 ≤ AHI <30), and 22.6% had severe OSA (AHI ≥30). Waist circumference (odds ratio 1.1; 95% CI 1.0–1.1; P = 0.03) was significantly related to the presence of OSA. Severe OSA was most likely in individuals with a higher BMI (odds ratio 1.1; 95% CI 1.0–1.2; P = 0.03).

CONCLUSIONS Physicians should be particularly cognizant of the likelihood of OSA in obese patients with type 2 diabetes, especially among individuals with higher waist circumference and BMI.


  • *A full list of the members of the Sleep AHEAD Research Group is available in an online appendix at

  • Clinical trial reg. no. NCT00194259,

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received September 26, 2008.
    • Accepted February 28, 2009.
  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.

| Table of Contents

This Article

  1. Diabetes Care vol. 32 no. 6 1017-1019
  1. Online-Only Appendix
  2. All Versions of this Article:
    1. dc08-1776v1
    2. 32/6/1017 most recent