ABSTRACT
OBJECTIVES: The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were to conduct a systematic review and meta-analysis comparing sleep in persons with and without T1D, and to explore relationships between sleep and glycemic control in T1D. METHODS: Studies were identified from Medline and Scopus. Studies reporting measures of sleep in T1D patients and controls, and/or associations between sleep and glycemic control, were selected. RESULTS: A total of 22 studies were eligible for the meta-analysis. Children with T1D had shorter sleep duration (mean difference [MD] = -26.4 minutes; 95% confidence interval [CI] = -35.4, -17.7) than controls. Adults with T1D reported poorer sleep quality (MD in standardized sleep quality score = 0.51; 95% CI = 0.33, 0.70), with higher scores reflecting worse sleep quality) than controls, but there was no difference in self-reported sleep duration. Adults with TID who reported sleeping >6 hours had lower hemoglobin A1c (HbA1c) levels than those sleeping ≤6 hours (MD = -0.24%; 95% CI = -0.47, -0.02), and participants reporting good sleep quality had lower HbA1c than those with poor sleep quality (MD = -0.19%; 95% CI = -0.30, -0.08). The estimated prevalence of obstructive sleep apnea (OSA) in adults with TID was 51.9% (95% CI = 31.2, 72.6). Patients with moderate-to-severe OSA had a trend toward higher HbA1c (MD = 0.39%, 95% CI = -0.08, 0.87). CONCLUSION: T1D was associated with poorer sleep and high prevalence of OSA. Poor sleep quality, shorter sleep duration, and OSA were associated with suboptimal glycemic control in T1D patients.
Subject(s)
Diabetes Mellitus, Type 1/physiopathology , Sleep , Diabetes Mellitus, Type 1/complications , Glycated Hemoglobin/analysis , Humans , Sleep/physiology , Sleep Wake Disorders/complications , Sleep Wake Disorders/physiopathologyABSTRACT
BACKGROUND: Diabetes and obstructive sleep apnoea (OSA) syndrome share a high prevalence in industrialized nations. The presence of OSA seems to promote the development of diabetes mellitus (DM) and vice versa. MATERIALS AND METHODS: In order to assess the prevalence of sleep disordered breathing, we studied 498 patients with DM type 2 and 58 patients with DM type 1 from 15 centres, using a screening device determining airflow and pulse oximetry. Age of the patients was 59.9 ± 13.1 years, mean body mass index was 31.9 ± 6.9 kg/m(2) . Duration of diagnosis of DM was 9.3 ± 7.3 years. RESULTS: Among the patients, 37.4% had an apnoea-hypopnoea index (AHI) ≥15/h suggestive of OSA. The prevalence of an AHI ≥ 15/h among the patients with DM type 1 was 10.3%. One hundred ninety-three (35.2%) patients suffered from neuropathy. We found a higher prevalence for neuropathy, nephropathy, hypertension, cardiovascular disease and heart failure in the group with an AHI ≥ 15/h. CONCLUSIONS: The prevalence of sleep disordered breathing is increased in patients with DM. Most of these patients had no typical clinical symptoms of OSA and would have been undiagnosed without diagnostic assessment of OSA.
