Home›Diabetes & Endocrinology› Prediabetes linked to 2.78-fold higher odds of obstructive sleep apnea in meta-analysis
Prediabetes linked to 2.78-fold higher odds of obstructive sleep apnea in meta-analysisPrediabetes Linked to Higher Risk of Obstructive Sleep Apnea
Frontiers in MedicinePublished July 30, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider screening for obstructive sleep apnea in patients with prediabetes, especially those under 55 years.
This meta-analysis of 8 cross-sectional studies involving 18,040 adults examined the association between prediabetes and obstructive sleep apnea syndrome (OSAS). The primary outcome was the prevalence of OSAS in individuals with prediabetes compared to normoglycemic controls.
The pooled analysis showed a significantly higher prevalence of OSAS in those with prediabetes (OR 2.78; 95% CI 1.99-3.87; p<0.001). Among the 18,040 participants, 6,325 (35.1%) had prediabetes. The association was stronger in younger populations (mean age <55 years; OR 3.44 vs. 2.06 in older groups; p=0.04) and when prediabetes was defined by composite diagnostic criteria versus single criteria (OR 3.40 vs. 1.92; p=0.01).
The authors note substantial heterogeneity (I²=83%) as a key limitation. Additionally, the cross-sectional design of included studies means the analysis can only demonstrate association, not causation. No data on adverse events or tolerability were reported.
Clinically, these findings suggest that screening for OSAS may be warranted in patients with prediabetes, particularly younger individuals. However, given the observational nature and high heterogeneity, these results should be interpreted cautiously and not used to infer a causal relationship.
How this fits prior evidence
This meta-analysis extends prior evidence linking diabetes to other comorbidities. Prior coverage showed that diabetes doubles the odds of moderate-to-severe hearing loss (especially in patients under 60). The current finding adds that prediabetes is also associated with increased odds of obstructive sleep apnea (OR 2.78), with a stronger association in younger adults. This complements earlier reports on prediction models for progression from prediabetes to type 2 diabetes, suggesting that OSAS may be an additional factor to consider in risk stratification.
Researchers analyzed data from over 18,000 adults to look at the link between prediabetes and obstructive sleep apnea. The study found that individuals with prediabetes were much more likely to have sleep apnea compared to those with normal blood sugar levels. This connection was even stronger in younger people under age 55.
The researchers also looked at how different diagnostic methods affected these results. They found a stronger link when using combined diagnostic criteria for prediabetes rather than just one single test. These findings suggest that doctors might consider screening patients for sleep apnea if they are diagnosed with prediabetes.
It is important to note that this study was based on cross-sectional data, which means it shows a link between the two conditions but does not prove that one causes the other. Because the study involved many different types of reports, the results may vary. You should talk to your doctor about how these findings apply to your specific health needs.
What this means for you:
People with prediabetes show a significantly higher link to obstructive sleep apnea, especially in younger adults.
Common questions
Is there a link between prediabetes and sleep apnea?
Yes, the study found a significantly higher prevalence of obstructive sleep apnea in people with prediabetes compared to those with normal blood sugar. The data showed an odds ratio of 2.78, meaning the link is quite clear across the studied groups.
Does this risk change based on age?
The link between prediabetes and sleep apnea appears stronger in younger people. Specifically, those under the age of 55 showed a higher association than those aged 55 and older. This suggests that younger adults with prediabetes may be at higher risk.
What does this mean for my treatment?
This study shows a link between the two conditions but does not prove that one causes the other. Because it is an observational analysis, you should speak with your doctor to see if sleep apnea screening is appropriate for your specific health situation.
BackgroundObstructive sleep apnea syndrome (OSAS) has been increasingly linked to metabolic dysfunction. However, the association between prediabetes and OSAS remains incompletely defined. This meta-analysis aimed to systematically evaluate the relationship between prediabetes and the prevalence of OSAS in adults.MethodsPubMed, Embase, and Web of Science were systematically searched to identify observational studies evaluating the association between prediabetes and objectively diagnosed OSAS. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models accounting for the influence of possible heterogeneity.ResultsEight cross-sectional studies comprising 18,040 participants were included, of whom 6,325 (35.1%) had prediabetes. Overall, individuals with prediabetes exhibited a significantly higher prevalence of OSAS compared with normoglycemic controls (OR = 2.78, 95% CI 1.99–3.87; p < 0.001), with substantial heterogeneity (I² = 83%). Sensitivity analyses confirmed the robustness of the findings (OR range: 2.47–3.08). Consistent associations were observed across Asian and Western populations, community-derived and high-risk populations, and across different diagnostic methods for OSAS. A stronger association was noted among studies with younger populations (mean age < 55 years vs. ≥ 55 years: OR 3.44 vs. 2.06; p for subgroup difference = 0.04) and when prediabetes was defined using composite diagnostic criteria rather than single criteria (OR 3.40 vs. 1.92; p = 0.01).ConclusionsPrediabetes is significantly associated with a higher prevalence of OSAS in adults. These findings highlight the frequent coexistence of early glucose dysregulation and sleep-disordered breathing and support consideration of OSAS screening in individuals with prediabetes.Systematic review registration, identifier CRD420261296015.
