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Many People with Type 2 Diabetes Need Better Sleep  

Mar 7, 2020
 
Editor: Steve Freed, R.PH., CDE

Author: Alayna Marteal Wyre, Pharm. D. Candidate, South College School of Pharmacy

Sleep Disorders, HbA1c, and their connection with type 2 diabetes patients. 

Interference with standard sleep patterns may be evaluated as a sleep disorder. Although prevalent in society, the adverse effects of sleep disorders are many, not limited to impairment, delayed reflexes, and possible negative effects on one’s daily lifestyle. Sleep disorders are prevalent in patients who have diabetes, and pose risks to their proper functioning. Inadequate and unhealthy amounts of sleep in persons with glycemic control discrepancies and type 2 Diabetes are a significant risk factor. Aside from multiple health issues that result in lessened or affected amounts of sleep, glycated hemoglobin A1c (HbA1c) and poor sleep in people with type 2 diabetes correlate directly.  

The purpose of the study is to unveil an accurate comparison and connection between sleep disorders and persons with diabetes. To complete this study, 172 participants with type 2 diabetes consented to “7-day wrist-actigraphy and slept questionnaires.” Measurements were taken to examine length of sleep, quality of sleep, initiation of deep sleep, the timing of initiation of deep sleep, and classifications of insomnia. It should be understood that these measurements are observed in addition to the observance of Hba1c levels. Linear regression methods are instrumental in the sleep measurement process. In addition to the use of linear regression, blood analysis, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index all are essential methods to evaluate sleep measurements properly.  

Significant differences were found to be more present and connected with “HbA1c (β = 0.239; P = 0.002; R2 = 4.9%), followed by total sleep duration (U-shaped: β = 1.161/β2 = 1.044; P = 0.017/0.032; R2 = 4.3%), subjective sleep quality (β = 0.191; P = 0.012; R2 = 3.6%), variability in midsleep time (β = 0.184; P = 0.016; R2 = 3.4%), and sleep efficiency (β = −0.150; R2 = 2.3%),” statistically speaking. However, there was no correlation or connection found that would be able to link Midsleep time and subjective insomnia symptoms with HbA1c. Conversely, measurements proved that when grouped together, sleep duration, total sleep duration, and subjective sleep quality were found to be both correlating and connecting factors to HbA1c.  Altered analyses displayed like reactions, despite counterarguments that focus on the lessening amounts of connecting evidence between total sleep duration and subjective sleep quality with HbA1c. 

The importance of examining the connection between Diabetes Mellitus and sleep disorder is again prevalent and highly concerning considering the number of diabetes patients affected. ESS results reveal that 54.40% of the patients experienced reoccurring daytime sleepiness. These same results were found to be consistent with results compiled by the PSQI results.  64.30% of the participants contained levels of poor sleep quality; in addition to the BQ results, 50.20% of the patients had a significantly higher possibility for risks about OSAS. Overall, this study found substantial sleep disorders in at least 50–64% of patients. The results of this study also adequately discovered and connected abnormal sleep quality and patients with diabetes. Abnormalities in sleep quality and condition are noted for their interference with HbA1c levels and their ability to heighten those levels. Multiple studies produced similar results and findings were considered cohesive. Studies have also shown connections that confirm that the progression and dominance of characteristics of diabetes are related to the quality and duration of sleep. Sleep abnormalities proved the association between “impaired glucose tolerance, increased type 2 diabetes, and elevated fasting blood glucose and HbA1c levels,” as well. There aren’t any clear limitations to the study as sleep disorders have been proven to be profoundly impairing. Further research and in-depth studies should focus on the solutions to improve sleep quality in patients with type 2 diabetes to gain a variety of results.  

In conclusion, sleep abnormalities and disorders are not uncommon in diabetes patients and contain adverse effects on diabetes development. Connectedly, if there is interference with the control mechanisms of diabetes, there is likely disruption pertaining to sleep quality. Amongst diabetes patients  with unsatisfactory and unhealthy blood glucose production, it should be considered more than necessary to address and resolve sleep-related issues, all aiming for eventual elimination and resolution of the negative factors directly affected by the sleep abnormalities and disorder, and also toward the hope to regain full mechanical and developmental control of diabetes. 

Practice Pearls:  

  • Measurements proved that when grouped, sleep duration, total sleep duration, and subjective sleep quality were found to be both correlating and connecting factors to HbA1c. 
  • Sleep abnormalities and disorders are not uncommon in diabetes patients and have negative effects on diabetes development. 
  • Amongst patients with unsatisfactory and unhealthy blood glucose production, it should be considered more than necessary to address and resolve sleep-related issues, 

 

Brouwer, A., Raalte, D. H. V., Rutters, F., Elders, P. J., Snoek, F. J., Beekman, A. T., & Bremmer, M. A. (2020). Sleep and HbA1c in Patients With Type 2 Diabetes: Which Sleep Characteristics Matter Most? Diabetes Care, 43(1), 235–243. doi: 10.2337/dc19-0550 

 

Alayna Marteal Wyre, Pharm. D. Candidate, South College School of Pharmacy 

 

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