Differences in relationships among sleep apnoea, glucose level, sleep duration and sleepiness between persons with and without type 2 diabetes.
Obstructive sleep apnoea is common in patients with diabetes. Recently, it was reported that short sleep duration and sleepiness had deleterious effects on glucose metabolism. Thereafter, several reports showed relationships between glucose metabolism and obstructive sleep apnoea, sleep duration or sleepiness. But the interrelationships among those factors based on recent epidemiological data have not been examined. We analysed data on 275 male employees (age, 44±8years; body mass index, 23.9±3.1kg m(-2) ) who underwent a cross-sectional health examination in Japan. We measured fasting plasma glucose, sleep duration using a sleep diary and an actigraph for 7days, and respiratory disturbance index with a type 3 portable monitor for two nights. Fifty-four subjects (19.6%) had impaired glucose metabolism, with 21 having diabetes. Of those 21 (body mass index, 25.9±3.8kgm(-2) ), 17 (81.0%) had obstructive sleep apnoea (respiratory disturbance index≥5). Regarding the severity of obstructive sleep apnoea, 10, four and three had mild, moderate and severe obstructive sleep apnoea, respectively. The prevalence of obstructive sleep apnoea was greater in those with than without diabetes (P=0.037). Multiple regression analyses showed that the respiratory disturbance index independently related to fasting plasma glucose only in the diabetic subjects. In patients with diabetes, after adjustment for age, waist circumference, etc. sleep fragmentation had a greater correlation with fasting plasma glucose than sleep duration, but without significance (P=0.10). Because the prevalence of obstructive sleep apnoea is extremely high in patients with diabetes, sufficient sleep duration with treatment for obstructive sleep apnoea, which ameliorates sleep fragmentation, might improve fasting plasma glucose.
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yuka
Y
Harada
Toru
T
Oga
Kazuo
K
Chin
Misa
M
Takegami
Ken-Ichi
K
Takahashi
Kensuke
K
Sumi
Takaya
T
Nakamura
Yukiyo
Y
Nakayama-Ashida
Itsunari
I
Minami
Sachiko
S
Horita
Yasunori
Y
Oka
Tomoko
T
Wakamura
Shunichi
S
Fukuhara
Michiaki
M
Mishima
Hiroshi
H
Kadotani
D056044:Actigraphy; D000328:Adult; D001786:Blood Glucose / Q000032:analysis* / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D055105:Waist Circumference / Q000502:physiology
D001786:Blood Glucose