Since we had ruled out other causes of hypoxia, we suspected this resulted from sleep-disordered breathing. Interestingly and unexpectedly, during the period where his blood glucose dropped, he also had corresponding falls in oxygen saturation. The blood glucose continued to fall for roughly an hour, where it remained stable at a healthy level for the remainder of the night. We superimposed his overnight oxygen with his blood glucose data and found that following his acute insulin injection, he had a rapid drop in blood glucose as expected. As a result, he only injected insulin after a meal in the evenings before bed to ensure blood sugars remained stable during sleep. He used insulin sparingly as he rarely consumed carbohydrates, mentioning that he prefers to use ketosis as a means to support his cycling performance. In this case study, the individual was a well-controlled non-obese male with type 1 diabetes with an athletic background. As a result, I have come up with a theory that I feel may contribute to solving the OSA crisis, or at least in part spur research or other means to treat sleep apnoea. One particular case study sparked an interest. As an additional measurement, we decided to monitor nocturnal blood glucose to see any relational changes in those who have evidence of SDB. We screened the patients for any cardiac pathology or other issues that may cause nocturnal hypoxia and used overnight pulse oximetry to measure blood oxygen to screen for SDB. SDB is an umbrella term for OSA, Central Sleep Apnoea, and Obesity Hypoventilation. Dr Milind Sovani and I at Nottingham University Hospitals decided to examine the prevalence of sleep-disordered breathing (SDB) in Adults with Type 1 diabetes. Therefore I felt that investigating in sleep would broaden my knowledge and make me a more rounded healthcare scientist.
I’d already experienced research in respiratory physiology in previous years when completing my research masters under Dr Michael Johnson and Professor Graham Sharpe at Nottingham Trent University. During the program, we had to produce a thesis and a scientific paper for our research studies. The recruitment process was competitive, and out of thousands of applicants, I was one of the very few to get a placement in the respiratory and sleep specialism.
It was a training program designed to handpick some of the UK’s top health science students and train them to become highly skilled practitioners, researchers, and clinical leaders. Roughly nine years ago, I enrolled on the National School of Healthcare Scientists training program in the NHS, UK.
Before we get there, let us discuss where it originated because that gives insight into why the curious excitement. However, I’m currently in a hospital bed and therefore thought it would be an excellent opportunity to use my brain to put together the evidence. It’s sometimes challenging to compile thoughts into scientific theories, as creative freedom disappears when required to do your day-to-day duties as a clinician. Over the years, staying up to date with relevant literature, I’ve developed a hypothesis as to why such individuals are susceptible to OSA despite not having the typical risk factors such as big round necks and large bellies. I have come across many executive directors and business owners who see no value in more than five hours of sleep and barely make time for their health. Evidentially and more noticeable, there is a significant increase in Obstructive sleep apnoea (OSA) in non-obese individuals living a career-driven and high-stress lifestyle. For the past nine years, I have worked as a clinical scientist specialising in respiratory and sleep. However, big pharma’s primary focus is on prolonging the lives of sick individuals rather than getting to the root cause of such diseases. Chronic disease, anxiety, and obesity are at an all-time high. Without a doubt, we are living in a time of a global health crisis.
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