Key result
OSA linked to ~52% lower parasympathetic activity during REM sleep in type 1 diabetes.
Why the study?
OSA with an AHI ≥ 15/h increases CVD risk in T1D, and CAN might be worsened by OSA-related autonomic nervous system dysfunction.
Does obstructive sleep apnea with AHI ≥ 15/h worsen autonomic nervous system control during sleep in adult patients with type 1 diabetes?
Observational (n=21)
Does obstructive sleep apnea with AHI ≥ 15/h worsen autonomic nervous system control during sleep in adult patients with type 1 diabetes?
In adults with type 1 diabetes, moderate-to-severe obstructive sleep apnea is associated with decreased parasympathetic activity and increased sympathetic activation during REM sleep, potentially driving future cardiovascular risk.
Associated with impaired autonomic control during REM in T1D; leaves open whether OSA treatment alters CV risk.
Obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) ≥ 15/h increases the cardiovascular disease (CVD) risk in type 1 diabetes (T1D). Cardiovascular autonomic neuropathy (CAN) is a key driver of CVD in diabetes and could be increased by autonomic nervous system (ANS) dysfunction related to OSA. We compared ANS control in T1D patients with AHI ≥ 15/h versus <15/h. T1D patients underwent polysomnography with heart rate variability analysis, cardiovascular reflex tests (CARTs), sudomotor function test, and urinary catecholamine analysis. Compared with patients with AHI < 15/h (n = 14), those with AHI ≥ 15/h (n = 7) showed a lower HFnu during REM sleep (12 ± 11 vs. 25 ± 14 nu, p < 0.05) and a higher heart rate (73 ± 8 vs. 64 ± 9 bpm; p < 0.05). A significantly higher urinary norepinephrine/epinephrine ratio was observed in patients with AHI ≥ 15/h. No significant group differences were observed regarding CAN. However, AHI correlated with systolic blood pressure at orthostatism (r = 0.54, p < 0.05). In T1D patients, OSA with AHI ≥ 15/h showed a lower parasympathetic activity and a sympathetic activation during sleep without any significant diurnal CAN proportion increase in patients with AHI ≥ 15/h. The potential impact of OSA on CAN and CVD risk in T1D patients should be assessed in further studies.
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Faivre et al. (2026) conducted an observational in Type 1 diabetes (n=21). Obstructive sleep apnea (AHI ≥ 15/h) vs. AHI < 15/h was evaluated on HFnu during REM sleep (p=<0.05). In type 1 diabetes, obstructive sleep apnea (AHI ≥ 15/h) was associated with lower parasympathetic activity during REM sleep (HFnu 12 vs 25 nu, p<0.05) compared to AHI < 15/h.
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