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Free Content Differences in relationships among sleep apnoea, glucose level, sleep duration and sleepiness between persons with and without type 2 diabetes

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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 ± 8 years; body mass index, 23.9 ± 3.1 kg 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 7 days, 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 ± 3.8 kg m−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.
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Document Type: Research Article

Affiliations: 1: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan 2: Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan 3: Department of Respiratory Medicine, Otsu Red Cross Hospital, Shiga, Japan 4: Department of Respiratory Medicine, National Hospital Organization Minami Kyoto Hospital, Kyoto, Japan 5: Department of Respiratory Medicine, Kyoto City Hospital, Kyoto, Japan 6: Horizontal Medical Research Organization, Graduate School of Medicine, Kyoto University, Kyoto, Japan 7: Department of Human Nursing, Faculty of Human Health, Sonoda Women’s University, Hyogo, Japan 8: Department of Sleep Control Medicine, Graduate School of Medicine, Ehime University, Ehime, Japan 9: Environmental Health Nursing, Graduate School of Medicine, Human Health Sciences, Kyoto University, Kyoto, Japan 10: Department of Epidemiology and Healthcare Research, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan 11: Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

Publication date: August 1, 2012

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