Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
Department of Big Data in Health Science, Zhejiang University School of Public Health and Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Sleep Res. 2023 Oct;32(5):e13917. doi: 10.1111/jsr.13917. Epub 2023 Apr 27.
The American Diabetes Association recommends a glycated haemoglobin target of less than 7% for treating type 2 diabetes mellitus. However, it is still being determined if poor sleep affects this therapeutic goal, despite being treated with the blood-glucose-lowering medication metformin. Thus, we used data from 5703 patients on metformin monotherapy participating in the UK Biobank baseline investigation between 2006 and 2010. We combined self-reported chronotype, daily sleep duration, insomnia, daytime sleepiness and snoring into a multidimensional poor sleep score ranging from 0 to 5, with higher scores indicating a less healthy sleep pattern. With each point increase on the poor sleep score scale, the odds of patients having an glycated haemoglobin of ≥ 7% increased by 6% (odds ratio [95% confidence interval], 1.06 [1.01, 1.11], p = 0.021). When examining the components of the poor sleep score separately, snoring was specifically associated with a glycated haemoglobin of ≥ 7% (1.12 [1.01, 1.25] versus no snoring, p = 0.038). However, adjusting for health and lifestyle conditions, such as body mass index, weekly physical activity level and hypertension status, eliminated the significant associations between the poor sleep score and snoring with glycated haemoglobin of ≥ 7%. Our findings suggest that poor sleep, specifically snoring, a symptom of obstructive sleep apnea, may interfere with the therapeutic goal of achieving a glycated haemoglobin below 7%. However, other factors known to be promoted by poor sleep, such as high body mass index, low physical activity and hypertension, may also contribute to the link between poor sleep and higher glycated haemoglobin levels.
美国糖尿病协会建议将糖化血红蛋白目标值控制在 7%以下，以治疗 2 型糖尿病。然而，尽管使用了降低血糖的二甲双胍药物进行治疗，睡眠质量差是否会影响这一治疗目标仍有待确定。因此，我们使用了 2006 年至 2010 年期间参加英国生物银行基线调查的 5703 名单独使用二甲双胍治疗的患者的数据。我们将自我报告的睡眠类型、每日睡眠时间、失眠、白天嗜睡和打鼾等因素合并为一个多维的睡眠质量评分，范围从 0 到 5，分数越高表示睡眠模式越不健康。睡眠质量评分每增加 1 分，糖化血红蛋白水平≥7%的患者的几率增加 6%（比值比[95%置信区间]，1.06[1.01，1.11]，p=0.021）。当分别检查睡眠质量评分的各个组成部分时，打鼾与糖化血红蛋白水平≥7%之间存在特定的关联（1.12[1.01，1.25]与无打鼾相比，p=0.038）。然而，当调整健康和生活方式等因素，如体重指数、每周身体活动水平和高血压状况时，睡眠质量评分与打鼾与糖化血红蛋白水平≥7%之间的显著关联就消失了。我们的研究结果表明，睡眠质量差，特别是打鼾，这是阻塞性睡眠呼吸暂停的一个症状，可能会干扰糖化血红蛋白水平低于 7%的治疗目标。然而，其他已知由睡眠质量差引起的因素，如体重指数高、身体活动水平低和高血压，也可能导致睡眠质量差与糖化血红蛋白水平升高之间存在关联。
