title: Delaying time to first nocturnal void may have beneficial effects on reducing blood glucose levels.
abstract: Experimental studies disrupting sleep and epidemiologic studies of short sleep durations indicate the importance of deeper and longer sleep for cardiometabolic health. We examined the potential beneficial effects of lengthening the first uninterrupted sleep period (FUSP) on blood glucose. Long-term data (≥3 months of treatment) were derived from three clinical trials, testing low-dose (10-100 µg) melt formulations of desmopressin in 841 male and female nocturia patients (90 % of which had nocturnal polyuria). We performed post hoc multiple regression with non-fasting blood glucose as dependent variable and the following potential covariates/factors: time-averaged change of FUSP since baseline, age, gender, race, ethnicity, baseline glucose, baseline weight, change in weight, patient metabolic status (normal, metabolic syndrome, type II diabetes), dose, follow-up interval, and time of random glucose sampling. Increases in FUSP resulted in statistically significant reductions in blood glucose (p = 0.0131), even after controlling for all remaining covariates. Per hour increase in time to first void was associated with glucose decreases of 1.6 mg/dL. This association was more pronounced in patients with increased baseline glucose levels (test of baseline glucose by FUSP change interaction: p < 0.0001). Next to FUSP change, other statistically significant confounding factors/covariates also associated with glucose changes were gender, ethnicity, metabolic subgroup, and baseline glucose. These analyses indicate that delaying time to first void may have beneficial effects on reducing blood glucose in nocturia patients. These data are among the first to suggest that improving sleep may have salutary effects on a cardiometabolic measure.
authors.affiliation: Faculty of Medicine and Health Sciences, University of Ghent, 9000, Ghent, Belgium. kvj@ferring.com.
authors.forename: Kristian Vinter
authors.initials: KV
authors.lastname: Juul
authors.affiliation: Department for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Jessen
authors.affiliation: Program in Sleep, Aging and Chronobiology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Bliwise
authors.affiliation: Ferring International PharmaScience Center, Copenhagen, Denmark.
authors.forename: Egbert
authors.initials: E
authors.lastname: van der Meulen
authors.affiliation: Faculty of Medicine and Health Sciences, University of Ghent, 9000, Ghent, Belgium.
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Nørgaard
mesh_terms: D000368:Aged; D050034:Antidiuretic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis*; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D053158:Nocturia / Q000097:blood* / Q000188:drug therapy; D012890:Sleep / Q000502:physiology*; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects* / Q000502:physiology
chemical_list: D050034:Antidiuretic Agents; D001786:Blood Glucose; D003894:Deamino Arginine Vasopressin
keywords: Blood glucose; Metabolic syndrome; Sleep disturbance