Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd, Ratchathewi, Bangkok, 10400, Thailand.
Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd, Ratchathewi, Bangkok, 10400, Thailand.
Acta Diabetol. 2018 Sep;55(9):917-925. doi: 10.1007/s00592-018-1166-3. Epub 2018 Jun 6.
Diabetes is linked to cognitive impairment. Sleep plays a role in memory consolidation. Sleep disturbances, commonly found in patients with diabetes, were shown to be related to cognitive dysfunction. This study explored the role of sleep in cognitive function of patients with abnormal glucose tolerance.
A total of 162 patients (81 type 2 diabetes and 81 prediabetes) participated. Sleep duration and sleep efficiency (an indicator of sleep quality) were obtained using 7-day actigraphy recordings. Obstructive sleep apnea (OSA) was screened using an overnight in-home monitor. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Three sub-scores of MoCA, visuoexecutive function, attention and delayed recall, were also analyzed.
Mean age was 54.8 (10.2) years. OSA was diagnosed in 123 participants (76.9%). Mean sleep duration was 6.0 (1.0) h and sleep efficiency was 82.7 (8.1) %. Sleep duration and OSA severity were not related to MoCA scores. Higher sleep efficiency was associated with higher MoCA scores (p = 0.003), and having diabetes (vs. prediabetes) was associated with lower MoCA scores (p = 0.001). After adjusting covariates, both having diabetes (vs. prediabetes) (B = - 1.137, p = 0.002) and sleep efficiency (B = 0.085, p < 0.001) were independently associated with MoCA scores. In addition, diabetes (B = - 0.608, p < 0.001) and sleep efficiency (B = 0.038, p < 0.001) were associated with visuoexecutive function. Sleep parameters were not related to delayed recall or attention scores.
Lower sleep efficiency is independently associated with lower cognitive function in patients with abnormal glucose tolerance. Whether sleep optimization may improve cognitive function in these patients should be explored.
糖尿病与认知障碍有关。睡眠在记忆巩固中起作用。在糖尿病患者中常见的睡眠障碍与认知功能障碍有关。本研究探讨了睡眠在葡萄糖耐量异常患者认知功能中的作用。
共有 162 名患者（81 名 2 型糖尿病患者和 81 名糖尿病前期患者）参与。使用 7 天活动记录仪记录睡眠时长和睡眠效率（睡眠质量的一个指标）。使用夜间家庭监测器筛查阻塞性睡眠呼吸暂停（OSA）。使用蒙特利尔认知评估（MoCA）评估认知功能。还分析了 MoCA 的三个子评分，即视空间执行功能、注意力和延迟回忆。
平均年龄为 54.8（10.2）岁。123 名参与者被诊断为 OSA（76.9%）。平均睡眠时长为 6.0（1.0）小时，睡眠效率为 82.7（8.1）%。睡眠时长和 OSA 严重程度与 MoCA 评分无关。较高的睡眠效率与较高的 MoCA 评分相关（p=0.003），且患有糖尿病（而非糖尿病前期）与较低的 MoCA 评分相关（p=0.001）。调整协变量后，糖尿病（vs. 糖尿病前期）（B=-1.137，p=0.002）和睡眠效率（B=0.085，p<0.001）与 MoCA 评分独立相关。此外，糖尿病（B=-0.608，p<0.001）和睡眠效率（B=0.038，p<0.001）与视空间执行功能相关。睡眠参数与延迟回忆或注意力评分无关。
较低的睡眠效率与葡萄糖耐量异常患者较低的认知功能独立相关。是否可以通过优化睡眠来改善这些患者的认知功能，还需要进一步研究。
