Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Diabetologia
Published in: Diabetologia 8/2011

Open Access 01-08-2011 | Article

Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus

Authors: M. van Dijk, E. Donga, J. G. van Dijk, G. J. Lammers, K. W. van Kralingen, O. M. Dekkers, E. P. M. Corssmit, J. A. Romijn

Published in: Diabetologia | Issue 8/2011

Login to get access

Abstract

Aims/hypothesis

Decreased sleep duration and/or impaired sleep quality negatively influence glucoregulation. The aim of this study was to assess subjective sleep characteristics in patients with type 1 diabetes, to relate sleep characteristics to long-term glycaemic control and to assess possible risk factors for impaired sleep.

Methods

We studied 99 adult patients with type 1 diabetes (55 men, 44 women, duration of diabetes 26.9 ± 1.2 years) and 99 age-, sex- and BMI-matched non-diabetic controls. Subjective sleep characteristics were assessed by validated questionnaires, i.e. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and the Berlin Questionnaire. Glucoregulation was assessed by HbA1c values. Clinical variables were obtained from medical charts. Depression was assessed by the Hospital Anxiety and Depression Scale (HADS). Peripheral polyneuropathy was assessed by neurological examination and quantitative sensory testing.

Results

Of the patients with type 1 diabetes, 35% had subjective poor sleep quality compared with 20% of the control participants (p = 0.021). A higher proportion of the patients with type 1 diabetes were at increased risk for obstructive sleep apnoea (OSA) (17.2% vs 5.1%, p = 0.012). There was no significant association between individual sleep characteristics and HbA1c values. On logistic regression analysis, the HADS depression score, presence of peripheral polyneuropathy, habitual snoring and other sleep disturbances (e.g. hypoglycaemia) were independently associated with poor sleep quality.

Conclusions/interpretation

Adult patients with long-standing type 1 diabetes mellitus have disturbed subjective sleep quality and a higher risk for OSA compared with control participants. Subjective sleep disturbances are part of the complex syndrome of long-standing type 1 diabetes.
Literature
1.
Skomro RP, Ludwig S, Salamon E, Kryger MH (2001) Sleep complaints and restless legs syndrome in adult type 2 diabetics. Sleep Med 2:417–422PubMedCrossRef
2.
Resnick HE, Redline S, Shahar E et al (2003) Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 26:702–709PubMedCrossRef
3.
Gottlieb DJ, Punjabi NM, Newman AB et al (2005) Association of sleep time with diabetes mellitus and impaired glucose tolerance. Arch Intern Med 165:863–867PubMedCrossRef
4.
Ayas NT, White DP, Al-Delaimy WK et al (2003) A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care 26:380–384PubMedCrossRef
5.
Yaggi HK, Araujo AB, McKinlay JB (2006) Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care 29:657–661PubMedCrossRef
6.
Spiegel K, Leproult R, van CE (1999) Impact of sleep debt on metabolic and endocrine function. Lancet 354:1435–1439PubMedCrossRef
7.
Donga E, van Dijk M, van Dijk JG et al (2010) A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab 95:2963–2968PubMedCrossRef
8.
Tasali E, Leproult R, Ehrmann DA, van CE (2008) Slow-wave sleep and the risk of type 2 diabetes in humans. Proc Natl Acad Sci USA 105:1044–1049PubMedCrossRef
9.
Jauch-Chara K, Schmid SM, Hallschmid M, Born J, Schultes B (2008) Altered neuroendocrine sleep architecture in patients with type 1 diabetes. Diabetes Care 31:1183–1188PubMedCrossRef
10.
Happe S, Treptau N, Ziegler R, Harms E (2005) Restless legs syndrome and sleep problems in children and adolescents with insulin-dependent diabetes mellitus type 1. Neuropediatrics 36:98–103PubMedCrossRef
11.
Matyka KA, Crawford C, Wiggs L, Dunger DB, Stores G (2000) Alterations in sleep physiology in young children with insulin-dependent diabetes mellitus: relationship to nocturnal hypoglycemia. J Pediatr 137:233–238PubMedCrossRef
12.
Villa MP, Multari G, Montesano M et al (2000) Sleep apnoea in children with diabetes mellitus: effect of glycaemic control. Diabetologia 43:696–702PubMedCrossRef
13.
Donga E, van Dijk M, van Dijk JG et al (2010) Partial sleep restriction decreases insulin sensitivity in type 1 diabetes. Diabetes Care 33:1573–1577PubMedCrossRef
14.
Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213PubMedCrossRef
15.
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed
16.
Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131:485–491PubMed
17.
Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the Restless Legs Syndrome Diagnosis and Epidemiology Workshop at the National Institutes of Health. Sleep Med 4:101–119PubMedCrossRef
18.
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef
19.
Bril V, Tomioka S, Buchanan RA, Perkins BA (2009) Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabet Med 26:240–246PubMedCrossRef
20.
Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24:1069–1078PubMedCrossRef
21.
Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B (2005) Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage 30:374–385PubMedCrossRef
22.
Yilmaz MB, Erdem A, Yalta K, Turgut OO, Yilmaz A, Tandogan I (2008) Impact of beta-blockers on sleep in patients with mild hypertension: a randomized trial between nebivolol and metoprolol. Adv Ther 25:871–883PubMedCrossRef
23.
Cicolin A, Mangiardi L, Mutani R, Bucca C (2006) Angiotensin-converting enzyme inhibitors and obstructive sleep apnea. Mayo Clin Proc 81:53–55PubMedCrossRef
24.
Golomb BA, Kwon EK CMDJ (2011) Abstract 3725: Simvastatin but not pravastatin affects sleep: findings from the UCSD Statin Study. Circulation 116:II_847 (Abstract)
25.
Vgontzas AN, Kales A, Bixler EO, Manfredi RL, Tyson KL (1991) Effects of lovastatin and pravastatin on sleep efficiency and sleep stages. Clin Pharmacol Ther 50:730–737PubMedCrossRef
26.
Eckernas SA, Roos BE, Kvidal P et al (1993) The effects of simvastatin and pravastatin on objective and subjective measures of nocturnal sleep: a comparison of two structurally different HMG CoA reductase inhibitors in patients with primary moderate hypercholesterolaemia. Br J Clin Pharmacol 35:284–289PubMed
27.
Ehrenberg BL, Lamon-Fava S, Corbett KE, McNamara JR, Dallal GE, Schaefer EJ (1999) Comparison of the effects of pravastatin and lovastatin on sleep disturbance in hypercholesterolemic subjects. Sleep 22:117–121PubMed
28.
Zelman DC, Brandenburg NA, Gore M (2006) Sleep impairment in patients with painful diabetic peripheral neuropathy. Clin J Pain 22:681–685PubMedCrossRef
29.
Raymann RJ, Swaab DF, van Someren EJ (2008) Skin deep: enhanced sleep depth by cutaneous temperature manipulation. Brain 131:500–513PubMedCrossRef
30.
Rutkove SB, Veves A, Mitsa T et al (2009) Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32:671–676PubMedCrossRef
31.
Borel AL, Benhamou PY, Baguet JP et al (2010) High prevalence of obstructive sleep apnoea syndrome in a type 1 diabetic adult population: a pilot study. Diabet Med 27:1328–1329PubMedCrossRef
32.
Ficker JH, Dertinger SH, Siegfried W et al (1998) Obstructive sleep apnoea and diabetes mellitus: the role of cardiovascular autonomic neuropathy. Eur Respir J 11:14–19PubMedCrossRef
33.
Bottini P, Dottorini ML, Cristina CM, Casucci G, Tantucci C (2003) Sleep-disordered breathing in nonobese diabetic subjects with autonomic neuropathy. Eur Respir J 22:654–660PubMedCrossRef
34.
Harsch IA, Schahin SP, Bruckner K et al (2004) The effect of continuous positive airway pressure treatment on insulin sensitivity in patients with obstructive sleep apnoea syndrome and type 2 diabetes. Respiration 71:252–259PubMedCrossRef
35.
Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE (2004) Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 160:521–530PubMedCrossRef
36.
Paranjape SA, Vavaiya KK, Kale AY, Briski KP (2006) Habituation of insulin-induced hypoglycemic transcription activation of lateral hypothalamic orexin-A-containing neurons to recurring exposure. Regul Pept 135:1–6PubMedCrossRef
37.
Knutson KL, Rathouz PJ, Yan LL, Liu K, Lauderdale DS (2006) Stability of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Questionnaires over 1 year in early middle-aged adults: the CARDIA Study. Sleep 29:1503–1506PubMed
38.
Buysse DJ, Reynolds CF III, Monk TH, Hoch CC, Yeager AL, Kupfer DJ (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14:331–338PubMed
Metadata
Title
Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus
Authors
M. van Dijk
E. Donga
J. G. van Dijk
G. J. Lammers
K. W. van Kralingen
O. M. Dekkers
E. P. M. Corssmit
J. A. Romijn
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 8/2011
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2184-7

Other articles of this Issue 8/2011

Diabetologia 8/2011 Go to the issue

Article

Osteopontin deficiency protects against obesity-induced hepatic steatosis and attenuates glucose production in mice

Article

Characterisation of glyoxalase I in a streptozocin-induced mouse model of diabetes with painful and insensate neuropathy

Article

Adoptive cell therapy using antigen-specific CD4−CD8− T regulatory cells to prevent autoimmune diabetes and promote islet allograft survival in NOD mice

Article

Genome-wide association and meta-analysis in populations from Starr County, Texas, and Mexico City identify type 2 diabetes susceptibility loci and enrichment for expression quantitative trait loci in top signals

Research Letter

Dipeptidyl peptidase-4 inhibition increases portal concentrations of intact glucagon-like peptide-1 (GLP-1) to a greater extent than peripheral concentrations in anaesthetised pigs

Commentary

The influence of sex and puberty on the progression of diabetic nephropathy and retinopathy
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits