Diabetes-Obstructive Sleep Apnea Treatment Trial

While diabetes self-management has been improved and refined over the last 30 years, many
persons with T2DM continue to have difficulty in achieving glycemic goals. Obstructive sleep
apnea (OSA) has a high prevalence among adults with type 2 diabetes (T2DM) and is associated
with excessive daytime sleepiness, impaired mood, decreased vigilance, and reduced functional
outcomes. The degree that OSA affects diabetes self-management, a known determinant of
glycemic control, remains unstudied.

The most effective treatment for OSA, continuous positive airway pressure (CPAP), results in
improved self-reported daytime functioning. However, the effect of CPAP treatment on
reception of diabetes education remains unknown. The underlying premise of the proposed study
from this new investigator is that OSA hinders diabetes self-management in adults with T2DM.

Our goal is to improve understanding of the effect of OSA on diabetes self-management and to
determine the efficacy of CPAP treatment in improving diabetes outcomes in adults treated
with CPAP compared to those on sham-CPAP. Expanding our understanding of the effect of sleep
disturbances on diabetes self-management may lead to improved guidelines for screening and
treatment of OSA in the increasingly large portion of the population with diabetes

Inclusion Criteria:

- Suboptimal glucose control (A1C ≥ 6.5%)

- Moderate-to-severe obstructive sleep apnea

- age 18 years and older

Exclusion Criteria:

- Poor glucose control (A1C > 11)

- Type 1 or gestational diabetes

- Sleep duration < 4 hrs

- Acute medical or surgical conditions or hospitalization ≤ 3 months

- Oxygen or bi-level PAP required

- Prior CPAP or persons in household with CPAP

- Employed in safety sensitive job