Altered neuroendocrine sleep architecture in patients with type 1 diabetes.
OBJECTIVE
The modulatory influence of nocturnal sleep on neuroendocrine secretory activity is increasingly recognized as a factor critical to health. Disturbances of sleep may arise from and contribute to the disease process in chronically ill patients with type 1 diabetes.


METHODS
Using standard polysomnography and repetitive blood sampling, neuroendocrine sleep architecture was assessed under well-controlled nonhypoglycemic conditions in 14 type 1 diabetic patients and 14 healthy control subjects matched for age, sex, and BMI.


RESULTS
As expected, plasma glucose (P = 0.02) and serum insulin (P < 0.001) levels were constantly higher in type 1 diabetic patients than in healthy subjects throughout the night. Beside these characteristic alterations of glucose metabolism, type 1 diabetic patients displayed higher blood levels of growth hormone (P = 0.001) and epinephrine (P = 0.02) during the entire night and higher levels of ACTH (P = 0.01) as well as a tendency toward higher cortisol levels (P = 0.072) during the first night-half, compared with healthy control subjects. Patients spent slightly less time in slow wave sleep (P = 0.09) during the first night-half (where this sleep stage predominates), and overall exhibited an increased proportion of stage 2 sleep (P = 0.01). Correspondingly, assessment of mood and symptoms after sleep revealed that subjective sleep was less restorative in type 1 diabetic patients than in healthy subjects.


CONCLUSIONS
Our data indicate distinct alterations in the neuroendocrine sleep architecture of patients with type 1 diabetes, which add to the generally adverse impact of the disease on the patients' health.
Jauch-Chara
Kamila
K
Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
Schmid
Sebastian M
SM
Hallschmid
Manfred
M
Born
Jan
J
Schultes
Bernd
B
D000204:Activity Cycles; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000339:Affect; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology* / Q000523:psychology; D004837:Epinephrine / Q000097:blood; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D009490:Neurosecretory Systems / Q000502:physiology*; D017286:Polysomnography; D012016:Reference Values; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology
D001786:Blood Glucose; D007328:Insulin; D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone; D004837:Epinephrine