06/01/2021    Richard Mann, DPM

Peripheral Neuropathy and Sleep Apnea

Summary: Obstructive sleep apnea (OSA) is a
common, independent, and often-overlooked cause
of peripheral neuropathy. Additionally, in type 2
diabetics, OSA has been shown to significantly
increase the odds of developing peripheral
neuropathy as well as increase the intensity of
neuropathic symptoms. Treatment of OSA by
continuous positive airway pressure (CPAP) may
diminish neuropathic symptoms. Physicians should
consider ordering sleep studies on those patients
suffering from peripheral neuropathy in which OSA
is suspected of being a contributing factor.

OSA is a common disorder characterized by
recurrent upper airway obstruction during sleep
resulting in intermittent hypoxemia. Its
prevalence increases with age. Lajoie, et al.
recently reported OSA to have a prevalence of
nearly 60% and 40%, respectively, in men and
women over 60 years of age. OSA is an independent
risk factor for peripheral neuropathy. In a
sample of people with OSA, Ludëmann found 71% had
clinical signs of polyneuropathy.

OSA has been shown to be a risk factor for the
development of diabetic peripheral neuropathy. A
meta-analysis of the scientific literature
indicated that diabetics with peripheral
neuropathy had an approximately 2-fold higher
prevalence of OSA than diabetics without
neuropathy. A 2012 British study found OSA
significantly increases the odds of type 2
diabetic patients developing peripheral
neuropathy and that the intensity of neuropathic
symptoms correlate with the severity of the
hypoxemia caused by the OSA.

Daytime sleepiness is a common symptom of OSA–
being present in more than 80% of patients.
Other signs and symptoms of OSA include loud
snoring, morning headache, difficulty
concentrating, etc.

Dziewas, et al., Schmidt, et al., and others have
shown that treatment of OSA with CPAP may
decrease neuropathic symptoms and improved nerve
function. OSA is also associated with decreased
cognitive function, stroke, Parkinson’s disease,
Alzheimer’s disease, hypertension and
cardiovascular disease. Physicians should
consider ordering sleep studies on those patients
suffering from peripheral neuropathy in which OSA
is suspected of being a contributing factor.

Richard Mann, DPM, Boca Raton, FL

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07/15/2021    Richard Mann, DPM

Peripheral Neuropathy and Sleep Apnea

Summary: Obstructive sleep apnea (OSA) is a
common, independent, and often-overlooked cause
of peripheral neuropathy. Additionally, in type 2
diabetics, OSA has been shown to significantly
increase the odds of developing peripheral
neuropathy as well as increase the intensity of
neuropathic symptoms. Treatment of OSA by
continuous positive airway pressure (CPAP) may
diminish neuropathic symptoms.

Physicians should consider ordering sleep studies
on those patients suffering from peripheral
neuropathy in which OSA is suspected of being a
contributing factor. OSA is a common disorder
characterized by recurrent upper airway
obstruction during sleep resulting in
intermittent hypoxemia. Its prevalence increases
with age. Lajoie, et al. recently reported OSA to
have a prevalence of nearly 60% and 40%,
respectively, in men and women over 60 years of
age. OSA is an independent risk factor for
peripheral neuropathy. In a sample of people with
OSA, Ludëmann found 71% had clinical signs of
polyneuropathy.

OSA has been shown to be a risk factor for the
development of diabetic peripheral neuropathy. A
meta-analysis of the scientific literature
indicated that diabetics with peripheral
neuropathy had an approximately 2-fold higher
prevalence of OSA than diabetics without
neuropathy. A 2012 British study found OSA
significantly increases the odds of type 2
diabetic patients developing peripheral
neuropathy and that the intensity of neuropathic
symptoms correlate with the severity of the
hypoxemia caused by the OSA.

Daytime sleepiness is a common symptom of OSA–
being present in more than 80% of patients.
Other signs and symptoms of OSA include loud
snoring, morning headache, difficulty
concentrating, etc.

Dziewas et al., Schmidt et al., and others have
shown that treatment of OSA with CPAP may
decrease neuropathic symptoms and improved nerve
function.

OSA is also associated with decreased cognitive
function, stroke, Parkinson’s disease,
Alzheimer’s disease, hypertension and
cardiovascular disease. Physicians should
consider ordering sleep studies on those patients
suffering from peripheral neuropathy in which OSA
is suspected of being a contributing factor.

Richard Mann, DPM (retired), Highland Beach, FL