Shorter sleep duration is associated with poorer glycemic control in type 2 diabetes patients with untreated sleep-disordered breathing
The purpose of this study is to explore the impact of sleep duration on glycemic control in type 2 diabetes patients with untreated sleep-disordered breathing (SDB).
Ninety type 2 diabetes patients participated in the study. SDB was diagnosed using an overnight in-home monitoring device (WatchPAT200). Sleep duration was recorded by wrist actigraphy for 7 days. Medical records were reviewed for hemoglobin A1c (HbA1c) values.
Seventy-one patients (78.8 %) were diagnosed with SDB [apnea-hypopnea index (AHI) ≥ 5]. In patients with SDB, there was no significant relationship between AHI and glycemic control. In addition, oxygen desaturation index, minimum oxygen saturation, and time spent below oxygen saturation of 90 % were not significantly correlated with glycemic control. Sleep duration, however, was inversely correlated with HbA1c (r = −0.264, p 0.026). Multiple regression analysis adjusting for age, sex, body mass index, insulin use, diabetes duration, and AHI revealed that sleep duration was significantly associated with HbA1c (p = 0.005). Each hour reduction in sleep duration was associated with a 4.8 % increase in HbA1c of its original value (95 % CI 1.5–8.0).
In type 2 diabetes patients with untreated SDB, shorter sleep duration was independently associated with poorer glycemic control. Sleep duration optimization may lead to improved glycemic control in this population.
KeywordsSleep-disordered breathing Obstructive sleep apnea Sleep duration Diabetes Glycemic control Short sleep duration
The study received grant support from Mahidol University.
Conflict of interest
S.R. received speaker honoraria from Sanofi Aventis and research grant from Merck. All other authors disclosed no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
- 1.American Academy of Sleep Medicine (2014) International classification of sleep disorders, 3rd edn. Darien, IllinoisGoogle Scholar
- 11.Knutson KL, Van Cauter E, Zee P, Liu K, Lauderdale DS (2011) Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study. Diabetes Care 34(5):1171–1176CrossRefPubMedPubMedCentralGoogle Scholar
- 14.National Sleep Foundation (2009) 2009 sleep in America poll. wwwsleepfoundationorg/Sleep-polls-Data/Sleep-in-America-Poll/2009-Health-and-Safety Assessed 1 April 2015
- 15.Priou P, Le VM, Meslier N, Paris A, Pigeanne T, Nguyen XL et al (2014) Cumulative association of obstructive sleep apnea severity and short sleep duration with the risk for hypertension. PLoS One 9(12): e115666.Google Scholar
- 20.WHO Western Pacific Region (2000). The Asia-Pacific perspective: redefining obesity and its treatment.Google Scholar
- 21.Association AD (2015) Standards of medical care in diabetes—2015. Diabetes Care 38(Suppl 1)Google Scholar
- 24.Nedeltcheva AV, Kessler L, Imperial J, Penev PD (2009) Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance. J Clin Endocrinol Metab 94(9):3242–3250CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Leproult R, Deliens G, Gilson M, Peigneux P (2015) Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction. Sleep 35(5):707–715Google Scholar