Reutrakul Sirimon, Thakkinstian Ammarin, Anothaisintawee Thunyarat, Chontong Sasipas, Borel Anne-Laure, Perfect Michelle M, Janovsky Carolina Castro Porto Silva, Kessler Romain, Schultes Bernd, Harsch Igor Alexander, van Dijk Marieke, Bouhassira Didier, Matejko Bartlomiej, Lipton Rebecca B, Suwannalai Parawee, Chirakalwasan Naricha, Schober Anne-Katrin, Knutson Kristen L
Division of Endocrinology and Metabolism, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Section for Clinical Epidemiology and Biostatistics, Faculty of Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Sleep Med. 2016 Jul;23:26-45. doi: 10.1016/j.sleep.2016.03.019. Epub 2016 Jun 8.
The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were to conduct a systematic review and meta-analysis comparing sleep in persons with and without T1D, and to explore relationships between sleep and glycemic control in T1D.
Studies were identified from Medline and Scopus. Studies reporting measures of sleep in T1D patients and controls, and/or associations between sleep and glycemic control, were selected.
A total of 22 studies were eligible for the meta-analysis. Children with T1D had shorter sleep duration (mean difference [MD] = -26.4 minutes; 95% confidence interval [CI] = -35.4, -17.7) than controls. Adults with T1D reported poorer sleep quality (MD in standardized sleep quality score = 0.51; 95% CI = 0.33, 0.70), with higher scores reflecting worse sleep quality) than controls, but there was no difference in self-reported sleep duration. Adults with TID who reported sleeping >6 hours had lower hemoglobin A1c (HbA1c) levels than those sleeping ≤6 hours (MD = -0.24%; 95% CI = -0.47, -0.02), and participants reporting good sleep quality had lower HbA1c than those with poor sleep quality (MD = -0.19%; 95% CI = -0.30, -0.08). The estimated prevalence of obstructive sleep apnea (OSA) in adults with TID was 51.9% (95% CI = 31.2, 72.6). Patients with moderate-to-severe OSA had a trend toward higher HbA1c (MD = 0.39%, 95% CI = -0.08, 0.87).
T1D was associated with poorer sleep and high prevalence of OSA. Poor sleep quality, shorter sleep duration, and OSA were associated with suboptimal glycemic control in T1D patients.
睡眠不足与2型糖尿病之间的关联已备受关注，但关于睡眠与1型糖尿病（T1D）的了解却很少。我们的目的是进行一项系统评价和荟萃分析，比较T1D患者与非T1D患者的睡眠情况，并探讨T1D患者睡眠与血糖控制之间的关系。
从Medline和Scopus数据库中检索研究。选取报告T1D患者和对照组睡眠测量指标，以及/或者睡眠与血糖控制之间关联的研究。
共有22项研究符合荟萃分析的条件。与对照组相比，T1D儿童的睡眠时间较短（平均差[MD]=-26.4分钟；95%置信区间[CI]=-35.4，-17.7）。与对照组相比，T1D成人报告的睡眠质量较差（标准化睡眠质量评分的MD=0.51；95%CI=0.33，0.70，分数越高表明睡眠质量越差），但自我报告的睡眠时间没有差异。报告睡眠时间>6小时的T1D成人的糖化血红蛋白（HbA1c）水平低于睡眠时间≤6小时的成人（MD=-0.24%；95%CI=-0.47，-0.02），报告睡眠质量良好的参与者的HbA1c低于睡眠质量差的参与者（MD=-0.19%；95%CI=-0.30，-0.08）。T1D成人中阻塞性睡眠呼吸暂停（OSA）的估计患病率为51.9%（95%CI=31.2，72.6）。中重度OSA患者的HbA1c有升高趋势（MD=0.39%，95%CI=-0.08，0.87）。
T1D与较差的睡眠和较高的OSA患病率相关。睡眠质量差、睡眠时间短和OSA与T1D患者血糖控制不佳有关。
