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Indirectly, this often occurs. In the case of sleep apnea, it is difficult for the individual to obtain stage 3 and 4 restful, deep delta wave sleep, due to the frequent lightening of sleep into stage 2, as a result of the multiple apneic episodes. As a result, there is usually significant daytime fatigue. The individual often compensates for the daytime lack of energy by consuming excess calories, typically in the form of processed carbohydrates (candy bars, sweets, sodas, etc.), and by doing so ends up gaining weight and becoming pre-diabetic and then overtly diabetic. In this sequence of events, hemoglobin A1C levels rise.

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