Approximately one-third of adolescents and adults in developed countries regularly experience insufficient sleep across the school and/or work week interspersed with weekend catch up sleep. This common practice of weekend recovery sleep reduces subjective sleepiness, yet recent studies demonstrate that one weekend of recovery sleep may not be sufficient in all persons to fully reverse all neurobehavioral impairments observed with chronic sleep loss, particularly vigilance. Moreover, recent studies in animal models demonstrate persistent injury to and loss of specific neuron types in response to chronic short sleep (CSS) with lasting effects on sleep/wake patterns. Here, we provide a comprehensive review of the effects of chronic sleep disruption on neurobehavioral performance and injury to neurons, astrocytes, microglia, and oligodendrocytes and discuss what is known and what is not yet established for reversibility of neural injury. Recent neurobehavioral findings in humans are integrated with animal model research examining long-term consequences of sleep loss on neurobehavioral performance, brain development, neurogenesis, neurodegeneration, and connectivity. While it is now clear that recovery of vigilance following short sleep requires longer than one weekend, less is known of the impact of CSS on cognitive function, mood, and brain health long term. From work performed in animal models, CSS in the young adult and short-term sleep loss in critical developmental windows can have lasting detrimental effects on neurobehavioral performance.
Aims
To examine whether there were significant differences in sleep during weekdays/weekends and whether the intra‐individual variability in sleep was related to glycaemic control in patients with type 2 diabetes.
Design
Correlational, longitudinal design.
Methods
Data were collected between February 2017–January 2018. In all, 56 adults with type 2 diabetes were included (60.7 years, 55.4% female). Sleep was measured using the Consensus Sleep Diary over 8 days. Intra‐individual variability of sleep was calculated as the standard deviation of sleep variables. Standard deviations of sleep duration, sleep efficiency, sleep quality, and mid‐sleep time were obtained. Glycaemic control was measured by haemoglobin A1C. Paired t test and multiple regression analysis were used.
Results
Overall, there were no differences in sleep parameters between weekdays and weekends. Participants slept 20 min more over the weekends than during weekdays. The mid‐sleep time during weekends was about 35 min later than during weekdays. Intra‐individual variability of sleep duration and mid‐sleep ranged from 27.6–167.4 min and 13–137 min, respectively. Controlling for covariates (e.g., distress, symptoms, and self‐care), larger variability in sleep duration, and mid‐sleep were significantly related to higher A1C levels.
Conclusion
Diabetes educators are recommended to include the assessment of intra‐individual variability in sleep. Maintaining a regular sleep habit (e.g., sleep duration and sleep timing) should be highlighted during patient education.
Impact
Intra‐individual variability in sleep is an alternative dimension for sleep assessment. This study examined whether intra‐individual variability in sleep was related to glycaemic control in an older sample of type 2 diabetes patients using a sleep diary across 8 days. This sample had a similar sleep pattern during weekdays and weekends. Larger intra‐individual variabilities in sleep duration and mid‐sleep time were independently related to worse glycaemic control. Diabetes patients are recommended to maintain a regular sleep routine.
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