Habitual sleep deprivation is associated with type 2 diabetes: a case-control study

Objectives: It is suggested that a minimum of eight hours of sleep per night is needed for metabolism to work normally. The aim of the study was to determine the association of habitual sleep deprivation and type 2 diabetes mellitus [T2DM]

Methods: We conducted a case-control study comparing patients with T2DM with age and sex matched healthy controls. Standard sleep questionnaires [the Berlin and Epworth Sleepiness Scale] and a weekly diary were used by patients to self-report habitual sleep

Results: A total of 172 diabetics and 188 healthy controls were enrolled in the study. There was a significant difference between T2DM and healthy controls in nocturnal sleep duration [p = 0.033]. There was a significant association between nocturnal sleep duration of fewer than six hours and T2DM [X[2] = 14.0; p = 0.0001]. There was no significant difference in daytime sleepiness and daytime naps between the T2DM and control groups [p = 0.452; p = 0.581, respectively]

Conclusions: A nocturnal sleep duration < 6 hours is associated with T2DM

White coat hypertension and masked hypertension among Omani patients attending a tertiary hospital for ambulatory blood pressure monitoring

Our study aimed to estimate the rate of white coat hypertension [WCH] and effect, and masked hypertension in patients attending a tertiary care hospital for 24 hour ambulatory blood pressure monitoring [24-h ABPM]. A total of 231 adult patients were referred to the Department of Clinical Physiology at Sultan Qaboos University Hospital, Muscat, for ABPM, between January 2010 and June 2012. The following data were gathered and analyzed: demographic data, clinic blood pressure [BP] measurements, and 24-h BP profile from ABPM. Thirty-two patients were excluded and the final analysis included 199 patients. There were 105 [52.8%] women and 94 [47.2%] men studied. The mean age of patients was 46 +/- 15 years and most patients were overweight with a mean BMI of 29.6 +/- 5 kg/m[2]. Around half of patients [53.8%] were on one or more antihypertensive medications. WCH was found in 10.6% and white coat effect was found in 16% of patients. The majority of patients [57%] with WCH were aged 40 years or above. Masked hypertension was present in 6% of patients and masked uncontrolled hypertension in 8.5% of patients. Our study showed that WCH and effect, and masked hypertension are common in hypertensive patients. Identifying these patients will have an impact on their management. However, the results of the study should be interpreted within the context of its limitations. Prospective randomized community and hospital-based studies should be conducted to estimate the true prevalence in the general population as well as in hypertensive patients

Familial clustering of type 2 diabetes among Omanis

The aim of this study was to screen Omani individuals for the familial aggregation of type 2 diabetes mellitus. A random cohort of 1182 Omani individuals visiting the Family Medicine Clinic at Sultan Qaboos University Hospital [SQUH], Muscat, Oman, for regular medical checkup, aged >/= 40 years, were sampled. Patients were categorized into three groups: [1] individuals who claim not to have diabetes and had no family history of diabetes; [2] individuals who claim not to have diabetes but had family history of diabetes; [3] individuals with diabetes. Only 16% of these Omani individuals had no diabetes and no family history of diabetes. Another separate random cohort of 234 Omani type 2 diabetes mellitus patients, from the Diabetes Clinic at SQUH, were interviewed and questioned about their family history of type 2 diabetes mellitus. Ninety five percent of the patients had a family history of diabetes. Eighty percent had first degree relatives with diabetes and 46% had second degree relatives with diabetes. At least one parent with diabetes was reported among 55% of these diabetics, while maternal diabetes [55%] was found to be higher than paternal diabetes [47%]. However, only 15% had both parents with diabetes. Furthermore, almost half of the 234 diabetics were having at least one of the following relatives with diabetes: brother, sister, aunt or an uncle. The findings of this study confirm familial aggregation of diabetes among the Omani population. Compared to other populations, familial aggregation of type 2 diabetes mellitus among Omanis is relatively very high, and is perhaps due to the very high degree of consanguinity among Omanis. Since almost everyone seems to have a genetic predisposition to diabetes, the dramatic lifestyle changes over the past 25 years, could tip the population into an epidemic of type 2 diabetes mellitus

Impaired fasting glucose in Omani adults with no family history of type 2 diabetes

The aim of this study was to estimate the prevalence of impaired fasting glucose [IFG] among Omani adults with no family history [FH] of diabetes and to investigate the factors behind the risk of developing type 2 diabetes [T2D], while excluding a FH of diabetes. A total of 1,182 Omani adults, aged >40 years, visited the Family Medicine and Community Health Clinic at Sultan Qaboos University Hospital, Oman, on days other than the Diabetes Clinic days, from July 2010 to July 2011. The subjects were interviewed and asked if they had T2D or a FH of T2D. Only 191 [16%] reported no personal history of T2D or FH of the disease. Of these, anthropometric and biochemical data was complete in 159 subjects. Of these a total of 42 [26%] had IFG according to the American Diabetes Association criteria. Body mass index, fasting insulin, haemoglobin A[1c] and blood pressure [BP], were significantly higher among individuals with IFG [P <0.01, P <0.05, P <0.01 and P <0.01, respectively]. In addition, fasting insulin, BP and serum lipid profile were correlated with obesity indices [P <0.05]. Obesity indices were strongly associated with the risk of IFG among Omanis, with waist circumference being the strongest predictor. Despite claiming no FH of diabetes, a large number of Omani adults in this study had a high risk of developing diabetes. This is possibly due to environmental factors and endogamy. The high prevalence of obesity combined with genetically susceptible individuals is a warning that diabetes could be a future epidemic in Oman

Gender difference in relationship of apnoea/hypopnoea index with body mass index and age in the Omani population

Obstructive sleep apnoea/hypopnoea syndrome [OSAHS] is a disorder characterised by repetitive upper airway collapse during sleep in association with daytime sleepiness. It has an estimated prevalence of 2% and 4% among middle-aged women and men respectively. The aim of the study was to look at the association of body mass index [BMI], age and gender and prevalence of OSAHS in the Omani population. Polysomnography reports and hospital medical records of all patients who took part in the Sleep Study at the Sleep Laboratory of the Clinical Physiology Department, Sultan Qaboos University Hospital, between January 1995 and December 2006, were retrospectively reviewed. Data from both sources was gathered and analysed. A total of 1,042 sleep studies were conducted with 608 valid studies for analysis. The study showed that the apnoea/ hypopnoea index [AHI] >15 was more prevalent in men compared to women [47.9% versus 33.5%, P = 0.001]. There was significant correlation of AHI with BMI [P <0.0001] among men compared to women [P = 0.1]; however, age was significantly correlated with AHI among women [P <0.0001], but not with men [P = 0.1]. The results indicate that there is a gender difference in the prevalence of OSAHS and obesity is a major risk factor for OSAHS among Omani men whereas age is found to be a risk factor for OSAHS among women

audit of the sleep medicine service in Oman

To audit the sleep service at Sultan Qaboos University Hospital [SQUH], Muscat, Oman, and to explore deficiencies to introduce new measures of improvement. Polysomnography [PSG] reports and SQUH medical records of all patients who underwent sleep studies from January 1995 to December 2006 in the sleep laboratory at SQUH were reviewed and analyzed. Out of a total of 1042 sleep studies conducted in the specified period, 768 PSG recordings were valid for analysis. The audit showed that the Otolaryngology Department was the main referring specialty for PSG [43%]. Snoring was the main symptom for 33% of the subjects referred, but suspicion of obstructive sleep apnea was the main reason for referral [38%]. Three quarters of the patients were males who were also younger, and with lower body mass index compared to females [p=0.0001 for all]. Despite large number of patients with an apnea-hypopnea index of >15 [n=261], only 94 [36%] patients received continuous positive airway pressure titrations and treatment. The sleep medicine service in SQUH provided the basic service, and raised the awareness of the importance of this specialty. However, substantial effort is required to bring it to international standards