ASSOCIATION BETWEEN BALANCE DYSFUNCTION AND SLEEP APNOEA IN TYPE II DIABETIC POPULATION: A CROSS-SECTIONAL STUDY

Abstract

Background: Type 2 Diabetes Mellitus T2DM) is associated with impaired postural control and an increased risk of falls, primarily due to diabetic neuropathy, proprioceptive deficits and musculoskeletal dysfunction. Obstructive sleep Apnoea (OSA), a common comorbidity in individuals with type 2 diabetes mellitus, may further compromise balance through intermittent hypoxia, sleep fragmentation and impaired sensorimotor integration. However, the influence of OSA risk on balance dysfunction among individuals with T2DM remains inadequately explored. Objective: To compare balance performance and sensory function between individuals with T2DM with and without risk of Obstructive sleep apnoea and to examine the relationship between STOP-BANG scores and balance-related outcome measures. Methods: This observational cross-sectional study included 64 adults with T2DM. Participants were categorized into two groups based on the STOP-BANG questionnaire; T2DM without risk of OSA and T2DM with risk of OSA. Functional balance was assessed using the Berg balance scale (BBS), while postural alignment was evaluated using computerized posturography. Peripheral sensory function was assessed using the 10-g Semmes-Weinstein monofilament test, 128Hz tuning form vibration perception test. Between group comparison were performed using Mann-Whitney test, Chi square test and the spearman’s rank correlation coefficient was used to analyse the correlation between STOP-BANG scores and balance related outcomes. Results: The T2DM at risk group demonstrated significantly lower Berg Balance Scale scores (p=0.02), greater knee malalignment (p=0.001), higher total body alignment scores (p-0.04), a greater proportion of participants with medium fall risk (p=0.01). Significant correlations were observed between STOP-BANG scores and Berg Balance Scale scores, as well as selected posturographt parameters (p<0.05). Conclusion: Individuals with T2DM who were at risk of OSA demonstrated poorer balance performance, greater postural alignment abnormalities and increased sensory impairment compared with those without OSA risk. These findings suggest that screening for OSA risk may help identify individuals with T2DM who are at increased risk of balance dysfunction and falls. Highlighting the importance of incorporating balance assessment into routine clinical evaluation.