Articlehybrid2013

Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes

Anne‐Laure Borel · Jean‐Louis Pépin · Laure Nasse · Jean-Philippe Baguet · S Netter · Pierre‐Yves Benhamou

76 citations0/0 files storedDiabetes Care

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Abstract

OBJECTIVE: Sleep 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 HbA1c levels in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Seventy-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. RESULTS: Patients having shorter sleep duration--less than 6.5 h (n=21)--had higher levels of HbA1c (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 HbA1c (R2=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. CONCLUSIONS: Shorter sleep duration is associated with higher HbA1c 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 HbA1c and blood pressure in type 1 diabetes.

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References

1989The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research 1999Impact of sleep debt on metabolic and endocrine function 2011The role and validity of actigraphy in sleep medicine: An update 2006Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem 2005Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes 2003A Prospective Study of Self-Reported Sleep Duration and Incident Diabetes in Women 2009Effects of poor and short sleep on glucose metabolism and obesity risk 2006Sleep Duration as a Risk Factor for the Development of Type 2 Diabetes

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