Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes
Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes
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DOI：
10.2337/dc12-2038
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发表时间：
2013-10-01
期刊：
影响因子：
16.2
通讯作者：
Benhamou, Pierre-Yves
中科院分区：
文献类型：
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作者：
Borel, Anne-Laure;Pepin, Jean-Louis;Benhamou, Pierre-Yves
目的睡眠限制与胰岛素敏感性恶化有关。短睡眠时间对 1 型糖尿病患者的影响鲜有研究。本研究解决了睡眠减少是否影响 1 型糖尿病患者 HbA(1c) 水平的问题。 研究设计和方法 招募了 79 名成年 1 型糖尿病患者（中位年龄 40 岁 [IQR 23-49]；47% 男性），连续 3 天佩戴腕部活动测量传感器，以评估正常日常生活中的平均睡眠时间。 37 名患者的子样本还进行了 24 小时动态血压监测 (ABPM)。对病史、睡眠问卷和糖尿病相关生活质量 (DQOL) 进行了评估。 结果睡眠时间短于 6.5 小时的患者 (n = 21) 的 HbA(1c) 水平 (P = 0.01) 高于睡眠时间长、超过 6.5 小时的患者 (n = 58)。在包括较短与较长睡眠时间、糖尿病病程、DQOL 评分和日常活动的多变量回归模型中，睡眠时间是唯一与 HbA(1c) 独立相关的变量 (R-2 = 10%)。在进行 24 小时 ABPM 的患者中，血压非下降模式的患者比血压下降模式的患者睡眠时间更短。 结论 较短的睡眠时间与 1 型糖尿病患者以及血压非下降模式患者的 HbA(1c) 水平较高相关，预计会对微血管并发症的风险产生长期有害影响。进一步的研究应该测试延长睡眠时间是否可以改善 1 型糖尿病患者的 HbA(1c) 和血压。
OBJECTIVESleep restriction has been associated with deteriorated insulin sensitivity. The effects of short sleep duration have been explored little in patients with type 1 diabetes. This study addresses the question of whether sleep curtailment affects HbA(1c) levels in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSSeventy-nine adult patients with type 1 diabetes (median age 40 years [IQR 23-49]; 47% men) were recruited to wear a wrist actimetry sensor during 3 consecutive days to assess mean sleep duration during normal daily life. A subsample of 37 patients also performed 24-h ambulatory blood pressure monitoring (ABPM). Medical history, sleep questionnaires, and diabetes-related quality of life (DQOL) were assessed.RESULTSPatients having shorter sleep durationless than 6.5 h (n = 21)had higher levels of HbA(1c) (P = 0.01) than patients with longer sleep duration, above 6.5 h (n = 58). In a multivariable regression model including shorter versus longer sleep duration, diabetes duration, DQOL score, and daily activity, sleep duration was the only variable independently associated with HbA(1c) (R-2 = 10%). In patients who performed 24-h ABPM, patients with a nondipping pattern of blood pressure exhibited shorter sleep duration than patients with a dipping pattern of blood pressure.CONCLUSIONSShorter sleep duration is associated with higher HbA(1c) levels in patients with type 1 diabetes, as well as with a nondipping pattern of blood pressure, anticipating a long-term deleterious impact on the risk of microvascular complications. Further studies should test whether extending the duration of sleep may improve both HbA(1c) and blood pressure in type 1 diabetes.