Skip to main content

Advertisement

Log in

Shorter sleep duration is associated with poorer glycemic control in type 2 diabetes patients with untreated sleep-disordered breathing

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

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).

Methods

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.

Results

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).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. American Academy of Sleep Medicine (2014) International classification of sleep disorders, 3rd edn. Darien, Illinois

    Google Scholar 

  2. Pamidi S, Tasali E (2012) Obstructive sleep apnea and type 2 diabetes: is there a link? Front Neurol 3:126

    Article  PubMed  PubMed Central  Google Scholar 

  3. Reutrakul S, Van Cauter E (2014) Interactions between sleep, circadian function, and glucose metabolism: implications for risk and severity of diabetes. Ann N Y Acad Sci 1311:151–173

    Article  CAS  PubMed  Google Scholar 

  4. St-Onge MP, Zammit G, Reboussin DM, Kuna ST, Sanders MH, Millman R, et al (2012) Associations of sleep disturbance and duration with metabolic risk factors in obese persons with type 2 diabetes: data from the Sleep AHEAD Study. Nat Sci Sleep 4:143–150

    Article  PubMed  PubMed Central  Google Scholar 

  5. Aronsohn RS, Whitmore H, Van Cauter E., Tasali E (2010) Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med 181(5): 507–513.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cappuccio FP, D'Elia L, Strazzullo P, Miller MA (2010) Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 33(2):414–420

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ohkuma T, Fujii H, Iwase M, Kikuchi Y, Ogata S, Idewaki Y, et al (2013) Impact of sleep duration on obesity and the glycemic level in patients with type 2 diabetes: the Fukuoka diabetes registry. Diabetes Care 36(3):611–617

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kim BK, Kim BS, An SY, Lee MS, Choi YJ, Han SJ, et al (2013) Sleep duration and glycemic control in patients with diabetes mellitus: Korea National Health and Nutrition Examination Survey 2007–2010. J Korean Med Sci 28(9):1334–1339

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tang Y, Meng L, Li D, Yang M, Zhu Y, Li C, et al (2014) Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus. Chin Med J 127(20):3543–3547

    PubMed  Google Scholar 

  10. Zheng Y, Wang A, Pan C, Lu J, Dou J, Lu Z, et al (2015) Impact of night sleep duration on glycemic and triglyceride levels in Chinese with different glycemic status. J Diabetes 7(1):24–30

    Article  CAS  PubMed  Google 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):1171–1176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Trento M, Broglio F, Riganti F, Basile M, Borgo E, Kucich C, et al (2008) Sleep abnormalities in type 2 diabetes may be associated with glycemic control. Acta Diabetol 45(4):225–229

    Article  CAS  PubMed  Google Scholar 

  13. Harada Y, Oga T, Chin K, Takegami M, Takahashi K, Sumi K, et al (2012) Differences in relationships among sleep apnoea, glucose level, sleep duration and sleepiness between persons with and without type 2 diabetes. J Sleep Res 21(4):410–418

    Article  PubMed  Google 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.

  16. Kim NH, Lee SK, Eun CR, Seo JA, Kim SG, Choi KM, et al (2013) Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults. Sleep 36(5):723–729

    PubMed  PubMed Central  Google Scholar 

  17. Chin K, Oga T, Takahashi K, Takegami M, Nakayama-Ashida Y, Wakamura T, et al (2010) Associations between obstructive sleep apnea, metabolic syndrome, and sleep duration, as measured with an actigraph, in an urban male working population in Japan. Sleep 33(1):89–95

    PubMed  PubMed Central  Google Scholar 

  18. Yuceege M, Firat H, Demir A, Ardic S (2013) Reliability of the Watch-PAT 200 in detecting sleep apnea in highway bus drivers. J Clin Sleep Med 9(4):339–344

    PubMed  PubMed Central  Google Scholar 

  19. Zou D, Grote L, Peker Y, Lindblad U, Hedner J (2006) Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography. Sleep 29(3):367–374

    PubMed  Google Scholar 

  20. WHO Western Pacific Region (2000). The Asia-Pacific perspective: redefining obesity and its treatment.

  21. Association AD (2015) Standards of medical care in diabetes—2015. Diabetes Care 38(Suppl 1)

  22. Louis M, Punjabi NM (2009) Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. J Appl Physiol 106(5):1538–1544

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Broussard JL, Ehrmann DA, Van Cauter E, Tasali E, Brady MJ (2012) Impaired insulin signaling in human adipocytes after experimental sleep restriction: a randomized, crossover study. Ann Intern Med 157(8):549–557

    Article  PubMed  PubMed Central  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):3242–3250

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Buxton OM, Pavlova M, Reid EW, Wang W, Simonson DC, Adler GK (2010) Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes 59(9):2126–2133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Spiegel K, Leproult R, Van Cauter E (1999) Impact of sleep debt on metabolic and endocrine function. Lancet 354(9188):1435–1439

    Article  CAS  PubMed  Google Scholar 

  27. Chen L, Pei JH, Chen HM (2014) Effects of continuous positive airway pressure treatment on glycaemic control and insulin sensitivity in patients with obstructive sleep apnoea and type 2 diabetes: a meta-analysis. Arch Med Sci 10(4):637–642

    Article  CAS  PubMed  PubMed Central  Google 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):707–715

  29. Killick R, Hoyos CM, Melehan KL, Dungan GC, Poh J, Liu PY (2015) Metabolic and hormonal effects of ‘catch-up’ sleep in men with chronic, repetitive, lifestyle-driven sleep restriction. Clin Endocrinol (Oxf). doi:10.1111/cen.12747

    Google Scholar 

Download references

Acknowledgments

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.

Ethical approval

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sirimon Reutrakul.

Additional information

N. S. and H. N. contributed equally to this manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Siwasaranond, N., Nimitphong, H., Saetung, S. et al. Shorter sleep duration is associated with poorer glycemic control in type 2 diabetes patients with untreated sleep-disordered breathing. Sleep Breath 20, 569–574 (2016). https://doi.org/10.1007/s11325-015-1243-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-015-1243-6

Keywords

Navigation