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Sleep is a complex behavioral state that occupies one-third of the human life span. Although viewed as a passive condition, sleep is a highly active and dynamic process. Sleep was considered to be primarily important for restoration of brain function. However, to date, there is increasing evidence that sleep also modulates the metabolic, endocrine and cardiovascular systems [Trenell, 2007; Boethel, 2002; Knutson & Van Cauter, 2007; Knutson, 2008]. It is known that if left untreated, sleep disorders can have significant impact on daytime function, including learning, memory, attention, and behavior. The approach to the treatment of these disorders (whether with or without pharmacotherapy) is dependent on a thorough evaluation of the sleep complaint and accurate diagnosis. Previous studies reported a consistent difference between diabetic and non-diabetic subjects in the number of sleep disturbances per hour, indicating possible influence of diabetes on sleep pattern [Resnick, 2003; Kawakami, 2004]. Several studies have shown that patients with T2DM sleep less than the general population [Vgontzas, 2000; Buxton, 2010]. A gradual decrease in self-reported sleep duration seems to have developed over the same period as the dramatic increase in the incidence of obesity and diabetes, including a close relationship between sleep cycle and diabetes [Van Cauter, 1997; Spiegel, 2005; Chasens, 2007; Knutson & Van Cauter, 2008]. Sleeping disorders related to T2DM include insomnia, restless leg syndrome, periodic leg movement disorder, excessive daytime sleepiness, sleepwalking, nightmares, narcolepsy, and SDB, especially SA. T2DM and SDB/SA are both prevalent diseases that share several risk factors, including advanced age and obesity [Tishler, 2003; Young, 1993]. T2DM is associated with higher incidence of cardiovascular, cerebrovascular, and renal diseases. There is also mounting evidence that SDB/SA is an independent risk factor for cardiovascular and cerebrovascular diseases. Interest in a potential independent link between the two diseases continues to grow.

Pathophysiology in Type 2 Diabetes – Type 2 Diabetes and Sleep-Disordered Breathing/Sleep Apnea – Role of Adipocytokines