Diabetes Research Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi-110025, India.
Diabetes Research Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi-110025, India.
Prim Care Diabetes. 2019 Oct;13(5):452-461. doi: 10.1016/j.pcd.2019.02.002. Epub 2019 Mar 5.
To investigate the association between sleep quality outcomes and measures of cardiac autonomic function and to assess the predictive ability of sleep quality outcomes for cardiac autonomic neuropathy (CAN) in type 2 diabetes mellitus (T2DM).
Fifty patients with T2DM (age, 51.3±7.01years; glycemic control, 8.4±1.65%) completed the study. Patients were diagnosed for CAN using the standard clinical autonomic test battery and were also assessed for heart rate variability (HRV) under resting conditions. Sleep quality was examined using the Pittsburg Sleep Quality Index (PSQI).
Sleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and global PSQI score showed significant correlations with measures of cardiac autonomic control (p<0.05). At an optimal cut-off of≤5.83h (area under the curve: 0.76, p=0.0003; sensitivity: 50%; specificity: 94.4%), sleep duration predicted occurrence of CAN (odds ratio, confidence interval: 0.18, 0.04-0.70; p=0.01) in T2DM after adjusting for various clinical confounders.
Findings of the present study suggest that subjective sleep outcomes such as sleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and overall sleep quality are associated with the indices of cardiac autonomic function in T2DM. Moreover, short sleep duration may be considered a predictor in the occurrence of CAN in these patients. Considering the role of sleep in the pathophysiology of CAN, sleep should be routinely examined in patients with T2DM and appropriate therapeutic interventions should be implemented particularly in case of reduced sleep duration.
探讨睡眠质量与心脏自主神经功能测量指标之间的关系，并评估睡眠质量对 2 型糖尿病（T2DM）患者心脏自主神经病变（CAN）的预测能力。
50 例 T2DM 患者（年龄 51.3±7.01 岁；血糖控制 8.4±1.65%）完成了这项研究。使用标准临床自主神经测试组合对患者进行 CAN 诊断，并在静息状态下评估心率变异性（HRV）。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。
睡眠时间、入睡潜伏期、睡眠效率、日间功能障碍和整体 PSQI 评分与心脏自主控制测量指标呈显著相关性（p<0.05）。睡眠持续时间的最佳截断值为≤5.83h（曲线下面积：0.76，p=0.0003；敏感性：50%；特异性：94.4%），可预测 T2DM 患者发生 CAN（优势比，置信区间：0.18，0.04-0.70；p=0.01），在调整各种临床混杂因素后。
本研究结果表明，T2DM 患者的主观睡眠结果，如睡眠时间、入睡潜伏期、睡眠效率、日间功能障碍和整体睡眠质量，与心脏自主功能指标相关。此外，睡眠时间较短可被视为这些患者发生 CAN 的预测因素。考虑到睡眠在 CAN 病理生理学中的作用，应在 T2DM 患者中常规检查睡眠，并在出现睡眠减少时应实施适当的治疗干预措施。
