SNORING AND DIABETES

By

R. Keith Campbell, RPh, FASHP, FAPhA, CDE

Associate Dean/Professor of Pharmacotherapy

Washington State University College of Pharmacy

Dr. Peter Forsham the noted diabetes specialist from the Univ. of California at San Francisco presented a lecture that I attended as a young professor that impressed me.  He stated  “if you know diabetes, you know medicine since diabetes effects every tissue and organ system from head to toe”.  He also cautioned that people with diabetes who get a particular health problem often assume that it is related to having diabetes and that is not necessarily so.  I often have patients ask me if their hang nail is caused by their diabetes.  The lesson here is two pronged.  First, diabetes patients get medical problems that having nothing to do with diabetes. Second, each problem that a diabetes patient confronts should be evaluated from a diabetes perspective. 

Recently, SNORING, has made the news and has been shown to be a risk factor for Type 2 diabetes.

In an article by Al-Delaimy, Manson, Willett, Stampfer and Hu in the Am. J Epidemiol in the March 1, 2002 issue it was reported that “snoring is independently associated with elevated risk of type 2 diabetes.”  They explained that obesity could also be a contributing factor.  The plain truth is that many people, both men and women, snore.  At first, when you hear someone snore it seems humorous but it isn’t funny, snoring is a health risk.

The Snoring Problem

The world is in the midst of an epidemic of diabetes and snoring.  Diabetes now affects over 17 million patients in the United States and those in the 30 plus year old age group face a 76% increasing prevalence of developing diabetes.  As people gain weight and develop diabetes and as they age, snoring becomes more of a problem.  We also know that diabetes equals cardiovascular disease and up to 80 percent of diabetes patients die from cardiovascular problems.  Patients with cardiovascular problems are also at a much higher risk of snoring.  It is estimated that 90 to 100 million Americans are adversely affected by snoring every night. Since snoring occurs more often as we age and since the average age of the U.S. population is increasing, snoring is expected to become even a larger problem. 

Some snorers have been recorded snores as high as 80 decibels that is equivalent to a jack hammer busting concrete.  Often the person who snores is not even aware of the problem.  It is the bed partner who often suffers the most.  Since snoring causes an adverse effect on sleeping it can result in many medical problems including stress, anxiety, exhaustion, irritability and even hostility.  Snoring is also known to exacerbate the risks associated with hypertension, obesity, resistance to infections (up to a 63 % reduction in the body’s natural defense process) and now diabetes.  According to the American Sleep Disorder Association, up to 80 percent of individuals with sleep disorders develop daytime sleepiness and drowsiness.  The results of this are shocking since people with sleep disorders have 7 times the likelihood of having a motor vehicle accident, have reduced job performance, an overall poorer quality of life, a greater chance to suffer from overweight conditions and sexual dysfunction.

People who are sleep deprived and snore eat on average twice as much as those who do not snore.

Note that up to 25% of patients with sleep disorders suffer from a serious condition called Sleep Apnea.  Sleep apnea is when a person periodically stops breathing during sleep. Sleep apnea occurs to the average person about 10 times a night but it becomes dangerous and a serious health problem when it occurs more often like up to 10 times an hour.  Snoring is one of the common symptoms of this condition and it is therefore usual to have patients sent to a physician or clinic that specializes in sleep disorders for a proper diagnosis.

The snoring noise is produced by intermittent vibration of soft palate tissue at the back of the throat when breathing flow is partially obstructed by the rapid opening and closing of the air passage during inhaling and exhaling.  The intensity of the noise is caused by the friction between the affected throat tissue and difficulty of air volume to get into the respiratory system.  The anatomical tissues involved when people snore are the back of the tongue, the soft palate and the uvula. 

Treating Snoring

The first steps in treating snoring include:  achieving the target blood glucose levels before and after meals; getting blood pressure to a level below 130/80 mm Hg, getting LDL cholesterol below 100 mg/dL and HDL and triglycerides to target levels and taking an aspirin tablet daily to reduce cardiovascular risks. It is also very important to have patients exercise and follow a good nutrition program; and, very importantly, stop smoking.  Patients with severe problems should see a sleep specialist to eliminate concerns about sleep apnea.  At present, the most common form of treatment is an elbow in the back or getting the patient to turnover.  This is disturbing to the snorer and his or her bed partner and nothing is solved. 

Some of the invasive treatment options include Uvulopalatoplasty often using laser treatments; Uvulopalatopharyngoplasty; radio-frequency reduction; palatal stiffening procedures and mandibular retainers.  The vast majority of patients with a snoring problem can be effectively treated with a product that lubricates the full range of the palate, the back of the tongue and very importantly, the uvula.  A desirable product for diabetes patients would be sugar-free, fructose-free, sorbitol-free and alcohol-free.  It should also be safe and effective.  Being sugar free has two advantages. First, the product would not have the potential to increase blood sugars and second, it would not have an adverse effect on gums and teeth.  Remember that diabetes patients have at least double the incidence of gum and tooth problems. 

Recently some products have been advertised in pharmacies and on infomercials that are lubricants, which moisten tissues and block the movement of the uvula and soften the palate to reduce snoring.  One product that is being advertised with diabetesincontrol.com is called Gluco-Free SnoreQuell.  It is safe and effective and studies are on-going to show its positive effects in diabetes patients.  The product is free of sugar, alcohol, fructose and sorbitol.  It contains natural oils like olive, sunflower, almond and sesame that are enclosed in a liposome that results in the oils being released over time.  These oils lubricate the soft tissues and uvula and prevent snoring.  The patient shakes the bottle and just before going to bed tilts his/her back and sprays the product 3 times to the back of the throat. The pleasant mint flavored product is held in the back of throat for 15-20 seconds and then swallowed.  The three sprays soothes and quiets the vibrations that cause the snoring.  It is safe, not habit forming, gentle, easy to use and is in a spray bottle that is portable.  It can be used by any person who snores but was designed for patients with diabetes or those who do not want to put a sugary product in their mouth just before going to bed.  It is also significantly less expensive than the products found in pharmacies or obtained after an infomercial. 

Conclusion

The incidence of both diabetes and snoring is exploding.  Both conditions need aggressive treatment with the objective of improving the outcomes of care of patients suffering from these conditions.  Recently, snoring has been found to be a risk factor for type 2 diabetes.  Patients who snore should be evaluated and can be treated with an effective and inexpensive product that lubribates the back of the tongue, soft palate and uvula that is designed for diabetes patients.  Click on the SnoreQuell link and learn more about the product.

http://www.diabetesincontrol.com/snorequell/index.htm