Altered sleep architecture in diabetes and prediabetes: findings from the Baependi Heart Study

Daniel M. Chen, Tâmara P. Taporoski, Shaina J. Alexandria, David A. Aaby, Felipe Beijamini, Jose E. Krieger, Malcolm von Schantz, Alexandre C. Pereira, Kristen L. Knutson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Study Objectives: People with diabetes and prediabetes are more likely to have sleep-disordered breathing (SDB), but few studies examined sleep architecture in people with diabetes or prediabetes in the absence of moderate-severe SDB, which was the aim of our cross-sectional study. Methods: This cross-sectional sample is from the Baependi Heart Study, a family-based cohort of adults in Brazil. About 1074 participants underwent at-home polysomnography (PSG). Diabetes was defined as fasting glucose >125 mg/dL or HbA1c > 6.4 mmol/mol or taking diabetic medication, and prediabetes was defined as HbA1c ≥ 5.7 & <6.5 mmol/mol or fasting glucose ≥ 100 & ≤125 mg/dl. We excluded participants with an apnea-hypopnea index (AHI) ≥ 30 in primary analyses and ≥ 15 in secondary analysis. We compared sleep stages among the 3 diabetes groups (prediabetes, diabetes, neither). Results: Compared to those without diabetes, we found shorter REM duration for participants with diabetes (−6.7 min, 95%CI −13.2, −0.1) and prediabetes (−5.9 min, 95%CI −10.5, −1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (−13.7 min, 95%CI −26.8, −0.6), longer slow-wave sleep (N3) duration (+7.6 min, 95%CI 0.6, 14.6) and higher N3 percentage (+2.4%, 95%CI 0.6, 4.2), compared to those without diabetes. Results were similar when restricting to AHI < 15. Conclusions: People with diabetes and prediabetes had less REM sleep than people without either condition. People with diabetes also had more N3 sleep. These results suggest that diabetes and prediabetes are associated with differences in sleep architecture, even in the absence of moderate-severe sleep apnea.

Original languageEnglish
Article numberzsad229
Issue number1
Early online date2 Sept 2023
Publication statusPublished - 1 Jan 2024

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