Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Wroclaw, Poland.
Department of Neurology, Wroclaw Medical University, Wroclaw, Poland.
Curr Neuropharmacol. 2021;19(1):78-91. doi: 10.2174/1570159X18666200309101750.
There is an increasing number of patients worldwide with sleep disturbances and diabetes. Various sleep disorders, including long or short sleep duration and poor sleep quality of numerous causes, may increase the risk of diabetes. Some symptoms of diabetes, such as painful peripheral neuropathy and nocturia, or associated other sleep disorders, such as sleep breathing disorders or sleep movement disorders, may influence sleep quality and quantity. Both sleep disorders and diabetes may lead to cognitive impairment. The risk of development of cognitive impairment in diabetic patients may be related to vascular and non-vascular and other factors, such as hypoglycemia, hyperglycemia, central insulin resistance, amyloid and tau deposits and other causes. Numerous sleep disorders, e.g., sleep apnea, restless legs syndrome, insomnia, and poor sleep quality are most likely are also associated with cognitive impairment. Adequate functioning of the system of clearance of the brain from toxic substances, such as amyloid β, i.e. glymphatic system, is related to undisturbed sleep and prevents cognitive impairment. In the case of coexistence, sleep disturbances and diabetes either independently lead to and/or mutually aggravate cognitive impairment.
全球患有睡眠障碍和糖尿病的患者人数不断增加。各种睡眠障碍，包括睡眠时间长或短以及睡眠质量差等多种原因，可能会增加患糖尿病的风险。糖尿病的一些症状，如疼痛性周围神经病变和夜间多尿，或相关的其他睡眠障碍，如睡眠呼吸障碍或睡眠运动障碍，可能会影响睡眠质量和数量。睡眠障碍和糖尿病都可能导致认知障碍。糖尿病患者发生认知障碍的风险可能与血管和非血管以及其他因素有关，如低血糖、高血糖、中枢胰岛素抵抗、淀粉样蛋白和 tau 沉积等原因有关。许多睡眠障碍，如睡眠呼吸暂停、不安腿综合征、失眠和睡眠质量差，也很可能与认知障碍有关。大脑清除有毒物质的系统（如淀粉样蛋白 β，即神经淋巴系统）的正常功能与睡眠不受干扰有关，并可预防认知障碍。在共存的情况下，睡眠障碍和糖尿病要么独立导致，要么相互加重认知障碍。
