Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Sleep Res. 2012 Aug;21(4):410-8. doi: 10.1111/j.1365-2869.2012.00997.x. Epub 2012 Feb 9.
Obstructive sleep apnoea is common in patients with diabetes. Recently, it was reported that short sleep duration and sleepiness had deleterious effects on glucose metabolism. Thereafter, several reports showed relationships between glucose metabolism and obstructive sleep apnoea, sleep duration or sleepiness. But the interrelationships among those factors based on recent epidemiological data have not been examined. We analysed data on 275 male employees (age, 44±8years; body mass index, 23.9±3.1kg m(-2) ) who underwent a cross-sectional health examination in Japan. We measured fasting plasma glucose, sleep duration using a sleep diary and an actigraph for 7days, and respiratory disturbance index with a type 3 portable monitor for two nights. Fifty-four subjects (19.6%) had impaired glucose metabolism, with 21 having diabetes. Of those 21 (body mass index, 25.9±3.8kgm(-2) ), 17 (81.0%) had obstructive sleep apnoea (respiratory disturbance index≥5). Regarding the severity of obstructive sleep apnoea, 10, four and three had mild, moderate and severe obstructive sleep apnoea, respectively. The prevalence of obstructive sleep apnoea was greater in those with than without diabetes (P=0.037). Multiple regression analyses showed that the respiratory disturbance index independently related to fasting plasma glucose only in the diabetic subjects. In patients with diabetes, after adjustment for age, waist circumference, etc. sleep fragmentation had a greater correlation with fasting plasma glucose than sleep duration, but without significance (P=0.10). Because the prevalence of obstructive sleep apnoea is extremely high in patients with diabetes, sufficient sleep duration with treatment for obstructive sleep apnoea, which ameliorates sleep fragmentation, might improve fasting plasma glucose.
阻塞性睡眠呼吸暂停在糖尿病患者中很常见。最近有报道称，睡眠时间短和嗜睡对葡萄糖代谢有不良影响。此后，有几项报告显示了葡萄糖代谢与阻塞性睡眠呼吸暂停、睡眠时间或嗜睡之间的关系。但是，基于最近的流行病学数据，这些因素之间的相互关系尚未得到检验。我们分析了日本 275 名男性员工（年龄 44±8 岁；体重指数 23.9±3.1kg m(-2)）的横断面健康检查数据。我们使用睡眠日记和活动记录仪测量了 7 天的空腹血浆葡萄糖、睡眠时间，并使用 3 型便携式监测仪测量了两晚的呼吸干扰指数。54 名受试者（19.6%）存在葡萄糖代谢受损，其中 21 名患有糖尿病。在这 21 名患者中（体重指数 25.9±3.8kg m(-2)），17 名（81.0%）患有阻塞性睡眠呼吸暂停（呼吸干扰指数≥5）。关于阻塞性睡眠呼吸暂停的严重程度，10 人、4 人和 3 人分别患有轻度、中度和重度阻塞性睡眠呼吸暂停。患有糖尿病的患者中阻塞性睡眠呼吸暂停的患病率高于无糖尿病的患者（P=0.037）。多元回归分析显示，仅在糖尿病患者中，呼吸干扰指数与空腹血浆葡萄糖独立相关。在糖尿病患者中，在调整年龄、腰围等因素后，睡眠碎片化与空腹血浆葡萄糖的相关性大于睡眠时间，但无统计学意义（P=0.10）。由于糖尿病患者中阻塞性睡眠呼吸暂停的患病率极高，因此通过治疗阻塞性睡眠呼吸暂停来保证充足的睡眠时间，改善睡眠碎片化，可能会改善空腹血糖水平。
