Sleep and type 2 diabetes mellitus- clinical implications.

Sleep is essential for life. Body systems require sleep of good quantity and quality for their proper functioning. Glucose metabolism can be affected adversely by several sleep disorders. Obstructive sleep apnea (OSA) is one of the most important disorder identified in the last 50 years which has systemic effects including glucose metabolism. Aging process also has its effects on glucose metabolism. There is a close relation between sleep, aging and metabolic syndrome. OSA and Type 2 Diabetes Mellitus (Type 2 DM) share several features in common. There is mounting evidence to show a close association between sleep deprivation, sleep disordered breathing-OSA, excessive sleepiness, insomnia, restless legs syndrome and Type 2 DM. The role of sleep deprivation, particularly REM sleep deprivation, in the genesis of obesity needs to be recognized. The close association of OSA with insulin resistance demands the recognition of OSA in fatty liver and polycystic ovary syndrome. Treatment of OSA by continuous positive airway pressure has been shown to increase insulin sensitivity. It is important for primary care physicians to have a high degree of suspicion of an underlying sleep disorder in patients with diabetes. Management of sleep disorder is highly rewarding.