Sleep Disorders in a Patient with Obesity and Type 2 Diabetes Mellitus

Aim. To demonstrate the features of diagnosis and treatment of sleep disorders in a patient with obesity and type 2 diabetes mellitus (T2DM), as well as to discuss the optimal strategies for comprehensive management of such patients in clinical practice.

Key points. Sleep disorders are an urgent problem in the context of obesity and T2DM due to the high prevalence of these comorbid conditions, their interrelated pathogenesis, their impact on cardiometabolic risks, and the difficulties in diagnosis and treatment. In this clinical case, modern methods were used to diagnose and treat sleep disorders in a patient with T2DM, including questionnaires, somnography (using the WatchPAT system), cognitive-behavioral therapy for insomnia, CPAP therapy, and laboratory and instrumental methods for diagnosing and treating T2DM. The use of a comprehensive approach significantly improved the patient's metabolic parameters, with a 26-kg weight loss and a decrease in glycated hemoglobin levels to 5.5%. The patient's sleep patterns also improved: decrease in the apnea/hypopnea index from 39.8 to 1 episode per hour against the background of CPAP therapy and up to 1.7 episodes per hour without ventilatory support, as well as a decrease in the severity of daytime drowsiness on the Epworth scale from 19 to 5 points (within the normal range).

Conclusion. On the example of the presented clinical case, the algorithm of management of patients with morbid obesity, T2DM, obstructive sleep apnea and insomnia is presented, which has practical significance for doctors. Analyzing this observation will help professionals make more informed decisions regarding the diagnosis, treatment, and monitoring of these comorbid diseases, which will improve the health and quality of life for patients.

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