Sleep biosignature of Type 2 diabetes: a case–control study. Issue 1 (9th July 2016)

• Record Type: Journal Article
• Authors: Lecube, A.; Romero, O.; Sampol, G.; Mestre, O.; Ciudin, A.; Sánchez, E.; Hernández, C.; Caixàs, A.; Vigil, L.; Simó, R.
• Is Part Of: Diabetic medicine. Volume 34:Issue 1(2017)
• Page Start: 79
• Page End: 85
• Publication Date: 2016-07-09
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13161
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aim: To determine whether or not the sleep disturbances associated with Type 2 diabetes affect the structure of sleep. Methods: We designed a case–control study in 76 patients with Type 2 diabetes and 76 control subjects without Type 2 diabetes, matched by age, gender, BMI and waist and neck circumferences. A subgroup of 32 patients with Type 2 diabetes was also matched with 64 control subjects without Type 2 diabetes according to apnoea‐hypopnoea index score. Examination included an overnight full polysomnography. Results: No differences in the percentage of time spent in either rapid eye movement or non‐rapid eye movement sleep were observed between groups; however, patients with Type 2 diabetes had more microarousal events during sleep than control subjects [41.4 (total range 4.0–104.4) vs 20.7 (total range 1.3–94.5) events/h; P < 0.001]. These differences were mainly observed during the non‐rapid eye movement sleep [7.4 (total range 0–107.2) vs 0.2 (total range 0–65.2) events/h; P < 0.001]. In addition, sleep variables related to oxygen saturation measures, such as the percentage of time spent with oxygen saturation ≤90%, were significantly greater during the rapid eye movement sleep in patients with Type 2 diabetes [20.3 (total range 0–99.2) vs. 10.5 (total range 0–94.0)%; P = 0.047]. This pattern was maintained in the subgroup of patients matched by apnoea‐hypopnaea index. Finally, stepwise regression analyses showed that apnoea‐hypopnoea index, the presence of Type 2 diabetes and fasting plasma glucose value were independently associated with the number of microarousals ( R 2 =0.667). Conclusions: Type 2 diabetes is associated with an altered sleep structure, with different effects according to rapid eye movement (increase in nocturnal hypoxia) or non‐rapid eye movement (increase in sleep fragmentation) sleep. What's new?: A complex cross‐talk between glucose homeostasis and sleep integrity exist. Type 2 diabetes shows a distinctive sleep architecture, with different effects according to rapid eye movement (REM) or non‐REM sleep. Type 2 diabetes favours intermittent hypoxia during REM sleep. Type 2 diabetes increases sleep fragmentation through higher rates of microarousals during non‐REM sleep.