Sleep disorders in diabetes mellitus type 1 depending on glycemia daily monitoring and achievement of glycemia target levels
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.
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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: 10.22141/2224-07188.8.131.524.77123.
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.
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