Tschepp Johanna, Lauer Christoph J, Wilde-Frenz Johanna, Pollmächer Thomas
Klinikum Ingolstadt, Centre of Mental Health, Ingolstadt, Germany.
Front Neurol. 2017 Jun 27;8:303. doi: 10.3389/fneur.2017.00303. eCollection 2017.
According to recent studies, sleep restriction and disruption both have a prominent negative influence on glucose metabolism. This could also be shown in sleep disorders, such as sleep apnea and the restless legs syndrome. However, similar studies regarding insomnia have not been that consistent, yet. Moreover, most previous studies did not include objective polysomnography (PSG) data.
Patients with primary insomnia ( = 17) and healthy controls ( = 15) were investigated using psychometric tests such as the Epworth Sleepiness Scale and the Pittsburgh sleep quality index (PSQI). Two nights of full PSG were performed in all subjects, and after the first PSG night subjects underwent a standard oral glucose tolerance test (OGTT). PSG-, arousal-, and glucose metabolism-parameters were compared between groups.
Patients with insomnia were, as expected, sleepier than healthy controls and showed higher PSQI values. All PSG parameters, however, including parameters related to nocturnal arousals, did not differ between groups. Moreover, OGGT results and all other parameters of glucose tolerance were not different between insomniac patients and healthy controls.
Our findings suggest that glucose tolerance is not impaired in patients with chronic insomnia and normal PSG-findings. Therefore, impaired glucose metabolism and diabetes related to insomnia in earlier studies might be restricted to those patients who have objectively disturbed sleep.
根据最近的研究，睡眠限制和睡眠中断对葡萄糖代谢均有显著负面影响。这在睡眠障碍中也有所体现，如睡眠呼吸暂停和不宁腿综合征。然而，关于失眠的类似研究结果尚未如此一致。此外，大多数先前的研究并未纳入客观的多导睡眠图（PSG）数据。
使用诸如爱泼华嗜睡量表和匹兹堡睡眠质量指数（PSQI）等心理测量测试对原发性失眠患者（n = 17）和健康对照者（n = 15）进行调查。所有受试者均进行两晚的全夜PSG监测，在第一个PSG监测夜后，受试者接受标准口服葡萄糖耐量试验（OGTT）。比较两组之间的PSG、觉醒和葡萄糖代谢参数。
正如预期的那样，失眠患者比健康对照者更易困倦，且PSQI值更高。然而，所有PSG参数，包括与夜间觉醒相关的参数，在两组之间并无差异。此外，失眠患者和健康对照者之间的OGGT结果及所有其他葡萄糖耐量参数也无差异。
我们的研究结果表明，慢性失眠且PSG结果正常的患者葡萄糖耐量未受损。因此，早期研究中与失眠相关的葡萄糖代谢受损和糖尿病可能仅限于那些客观睡眠受到干扰的患者。
