Sleep disorders in diabetes mellitus type 1 depending on glycemia daily monitoring and achievement of glycemia target levels
Keywords:type 1 diabetes mellitus, sleep disorders, daily monitoring of glycemia
Background. Sleep disorders occur in more than 50 % of the population of developed countries. Changes both in the structure and duration of sleep impact the somatic state of patients. The role of sleep is significant for the regulation of various body functions, hormone secretion, metabolic processes, and glucose homeostasis. The purpose of the study was to access sleep parameters and respiratory events of sleep depending on glycemia level during sleep for patients with type 1 diabetes mellitus. Materials and methods. The study involved 57 patients with type 1 diabetes. Depending on glycemia level during sleep all patients were divided into 3 groups: group 1 (n = 14) included the patients with sleeping glucose less than 3.9 mmol/l; group 2 (n = 25) included the patients with glycemic value 3.9–6.9 mmol/l; group 3 (n = 18) — 7.0–10.0 mmol/l. Glycated hemoglobin, daily monitoring of glycemia, polysomnography were determined in all patients. Results. The study found insufficient duration of total sleep time, a lack of slow sleep stages, more pronounced in patients with decompensation and nocturnal hypoglycemia regardless of diabetes compensation and sleeping hypoglycemia presence. Obstructive sleep apnea is more common in patients with sleeping hypoglycemia, the average duration of this apnea increases with a decrease in the mean value of glycemia on the day before bedtime. Conclusions. The revealed disturbances in sleep structure and the peculiarities of respiration in a sleep with type 1 diabetes can be one of the reasons for the decline in the quality of life of patients with type 1 diabetes.
Kovalzon VМ. Osnovy isomnologii: fiziologiya i neyrohimiyatsikla ‘bodrstvovanie-son’ [Fundamentals of somnology: physiology and neurochemistry of the cycle ‘wakefulness-sleep’]. Moscow: BINOM. Laboratoriya znanii; 201. :240 р. (In Russian).
Pallayova M, Donic V, Gresova S, Peregrim I, Tomori Z. Do differences in sleep architecture exist between persons with type 2 diabetes and nondiabetic controls. Diabetes Sci. Technology. 2010;4(2):344-52. doi: 10.1177/193229681000400215.
Doroshkevich IP, Mokhort TV. Assessment of Glycemia Impact on the Parameters of Sleep in Type 1 Diabetes Mellitus: the Results of Cross-Sectional Cohort Trial. Mezhdunarodnyiy Eendokrinologicheskii Zhurnal. 2014;7(63):23-27. (In Russian). doi: 10.22141/2224-07126.96.36.1994.77123.
Rechtschaffen A, Kales А. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington: Government printing office; 1968. 59 p.
Bassetti C. ESRS European sleep medicine textbook. Bonn: VG Bild-Kunst; 2014. 300 p.
Feupe SF, Frias PF, Mednick SC, McDevitt EA, Heintzman ND. Nocturnal continuous glucose and sleep stage data in adults with type 1 diabetes in real-world conditions. Diabetes Sci Technol. 2013 Sep 1;7(5):1337-1345. doi: 10.1177/193229681300700525.
Spiegel K, Knutson K, Leproult R, Tasali E, Van Cauter E. Sleep loss: a novel risk factor for insulin resistance and type 2 diabetes. Appl. Physiol. 2005;99(5):2008-19. doi: 10.1152/japplphysiol.00660.2005.
Koren D, Levitt Katz LE, Brar PC, Gallagher PR, Berkowitz RI, Brooks LJ. Sleep architecture and glucose and insulin homeostasis in obese adolescents. Diabetes Care. 2011;34(11):2442-7. doi: 10.2337/dc11-1093.
Schultes B, Jauch-Chara K, Gais К, et al. Defective awakening response to nocturnal hypoglycemia in patients with type 1 diabetes mellitus. Plos Med. 2007;4(2):164-80. doi: 10.1371/journal.pmed.0040069.
Meyer L. Prevalence of obstructive sleep apnea (OSA) in patients with type 1 diabetes and impact on glucose profile. Available from: http://www.abstractsonline.com/pp8/#!/3699/presentation/8579.
Sakovich OM. Kliniko-funkcional'naja harakteristika respiratornoj i kardiovaskuljarnoj sistem u bol'nyh saharnym diabetom 1 tipa [Clinical and functional characterization of respiratory and cardiovascular systems in patients with diabetes type 1]. Krasnoyarsk; 2010. 26 p. (In Russian).
Manin G, Pons A, Baltzinger P, et al. Obstructive sleep apnoea in people with type 1 diabetes: prevalence and association with micro- and macrovascular complications. Diabet Med. 2015;32(1):90-96. doi: 10.1111/dme.12582.
Janovsky CC, Rolim LC, de Sá JR, Poyares D, Tufik S, Silva AB, Dib SA. Cardiovascular autonomic neuropathy contributes to sleep apnea in young and learn type 1 diabetes mellitus patients. Front Endocrinol (Lausanne). 2014 Aug;5:119. doi: 10.3389/fendo.2014.00119.
Copyright (c) 2020 T.V. Mokhort, I.P. Darashkevich
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.