TY - JOUR
T1 - Altered sleep architecture in diabetes and prediabetes
T2 - findings from the Baependi Heart Study
AU - Chen, Daniel M.
AU - Taporoski, Tâmara P.
AU - Alexandria, Shaina J.
AU - Aaby, David A.
AU - Beijamini, Felipe
AU - Krieger, Jose E.
AU - von Schantz, Malcolm
AU - Pereira, Alexandre C.
AU - Knutson, Kristen L.
N1 - Funding: This work was supported by NIH grant 1R01HL141881.
PY - 2023/9/2
Y1 - 2023/9/2
N2 - Study ObjectivesPeople 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.MethodsThis cross-sectional sample is from the Baependi Heart Study, a family-based cohort of adults in Brazil. 1,074 participants underwent at-home polysomnography (PSG). Diabetes was defined as fasting glucose>125mg/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).ResultsCompared to those without diabetes, we found shorter REM duration for participants with diabetes (-6.7min, 95%CI -13.2, -0.1) and prediabetes (-5.9min, 95%CI -10.5, -1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (-13.7min, 95%CI -26.8, -0.6), longer slow-wave sleep (N3) duration (+7.6min, 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.ConclusionsPeople 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.
AB - Study ObjectivesPeople 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.MethodsThis cross-sectional sample is from the Baependi Heart Study, a family-based cohort of adults in Brazil. 1,074 participants underwent at-home polysomnography (PSG). Diabetes was defined as fasting glucose>125mg/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).ResultsCompared to those without diabetes, we found shorter REM duration for participants with diabetes (-6.7min, 95%CI -13.2, -0.1) and prediabetes (-5.9min, 95%CI -10.5, -1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (-13.7min, 95%CI -26.8, -0.6), longer slow-wave sleep (N3) duration (+7.6min, 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.ConclusionsPeople 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.
KW - polysomnography
KW - epidemiology
KW - rapid-eye-movement sleep
KW - REM sleep
KW - non-REM sleep
U2 - 10.1093/sleep/zsad229
DO - 10.1093/sleep/zsad229
M3 - Article
JO - Sleep
JF - Sleep
SN - 0161-8105
M1 - zsad229
ER -
