Home / Resources / Articles / Daytime Sleepiness Increases the Risk for Severe Hypoglycemia

Daytime Sleepiness Increases the Risk for Severe Hypoglycemia

Oct 17, 2013
 

Patients with diabetes who are excessively sleepy during the day may be at a higher risk for hypoglycemia…. 

Sleep-disordered breathing and the daytime tiredness that comes with it are common in type 2 diabetes. In a subgroup analysis from a large observational study, researchers found that patients who had higher scores on two different scales of daytime sleepiness were significantly more likely to have suffered from severe hypoglycemia (P=0.016 and P=0.024, respectively). The 898 participants in the study, who had a mean age of 67.9 years, completed two questionnaires on sleep-disordered breathing and daytime sleepiness, the Epworth Sleepiness Scale and the Berlin Questionnaire. They were also asked about episodes of severe hypoglycemia.

 

Inkster et al found that subjects who scored highly on the Epworth Sleepiness Scale were significantly more likely to have suffered from severe hypoglycemia than those with low scores (15.6% versus 9%, P=0.016). A positive score in the "sleepiness" category of the Berlin Questionnaire was also associated with a history of previous severe hypoglycemia compared with a negative score (13% versus 8%, P=0.024), they reported. The overall Berlin score, however, wasn’t related to severe hypoglycemia, and in regression analyses controlling for several factors including age, sex, duration of diabetes, HbA1c, body mass index, and treatment type, the Berlin sleepiness category was no longer significant. Epworth Sleepiness Scale score, on the other hand, maintained its significance in those analyses.

The researchers stated that the study was limited by its cross-sectional design, and the findings need to be replicated by collecting prospective data on hypoglycemia and other important confounding factors.

Practice Pearls: 
  • Subjects who scored highly on the Epworth Sleepiness Scale were significantly more likely to have suffered from severe hypoglycemia.
  • A positive score in the "sleepiness" category of the Berlin Questionnaire was also associated with a history of previous severe hypoglycemia.
  • Sleep-disordered breathing and the daytime tiredness that comes with it are common in type 2 diabetes.

Diabetes Care, October 2013