Excessive daytime sleepiness in type 2 diabetes

Abstract

Objective: To examine excessive daytime sleepiness (EDS) in type 2 diabetes. Subjects and methods: Patients (N = 110) were evaluated regarding Epworth Sleepiness Scale (EDS), sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Beck Depression Inventory), Restless Legs Syndrome (RLS), risk of obstructive sleep apnea (OSA) (Berlin questionnaire), and comorbidity severity (Charlson Comorbidity Index). Patients were compared with indivi duals with arterial hypertension and without diabetes. Results: Diabetic patients had more EDS, depressive symptoms, and higher comorbidity severity than hypertensive patients (p < 0.005). In diabetic patients, poor quality sleep (53.3%), and high risk of OSA (40.9%) and RLS (14.5%) were found; EDS (55.5%) was associated with depressive symptoms present in 44.5% indivi duals (OR = 1.08; 95% CI: 1.01 1.15), and remained so after data were controlled for age, gender, body mass index, and glycated hemoglobin (OR = 2.27; 95% CI 1.03 5.03). Conclusions: Sleep abnormalities are frequent. EDS affects most of the patients and is independently associated with depressive symptoms. Adequate antidepressant therapy should be tested for the effects on EDS. Arq Bras Endocrinol Metab. 2013;57(6):425-30 Keywords Diabetes; sleep; depression; apnea; comorbidity RESUMO Objetivo: Em pacientes com diabetes tipo 2, avaliar a sonolência excessiva diurna (SED). Sujeitos e métodos: Pacientes (N = 110) foram investigados com relação a Escala de Sonolência de Epworth (SED), qualidade do sono (Índice de Qualidade de Sono Pittsburgh), sintomas depres sivos (Inventário de Depressão de Beck), Síndrome das Pernas Inquietas (SPI), risco de apneia obstrutiva do sono (AOS) (Questionário de Berlim) e comorbidades (Índice de Comorbidade de Charlson), e foram comparados com indivíduos com hipertensão arterial sem diabetes. Resultados: Pacientes diabéticos apresentavam mais SED, sintomas depressivos e comorbidades que os hipertensos (p < 0,005). Em pacientes diabéticos, má qualidade do sono (53,3%), risco de AOS (40,9%) e SPI (14,5%) foram encontrados. SED (55,5%) associou se com os sintomas depressivos em 44,5% (OR = 1,08; 95% IC 1,01 1,15) e permaneceu após controle para idade, sexo, índice de massa corporal e hemoglobina glicosilada (OR = 2,27 95% IC 1,03 5,03). Conclusões: Anormalidades do sono são frequentes. SED afeta a maioria dos pacientes e associa se de forma independente com os sintomas depressivos. Terapia antidepressiva pode melhorar a SED. Arq Bras Endocrinol Metab. 2013;57(6):425-30

Daytime sleepiness in patients with type 2 Diabetes Mellitus – a prospective cohort study

“…In agreement with our findings, sex differences were described in T2D: depression affected more women and lack of exercise and degree of apnea were more frequent in men [35]. Previously, female gender was associated with worse daytime sleepiness [4,36]. In partial agreement, this study showed that women evolved with more daytime sleepiness after two years.…”

“…Previous studies suggest that diabetic patients are more likely to be sleepy during the daytime than non-diabetics [4][5][6] Patients with type 2 diabetes (T2D) commonly present with sleep abnormalities e.g. restless legs syndrome [7], obstructive sleep apnea [8], circadian alterations [9] and nervous system abnormalities [10,11].…”

“…Importantly, poor sleep quality affects more than half of patients with T2D and relates to depressive symptoms [16]. Arterial hypertension, cerebrovascular events, anxiety, depression, cognitive alterations and dementia are other comorbidities frequent in T2D that potentially influence daytime sleepiness [4,[17][18][19]. All this evidence demonstrate that these comorbid conditions are multilaterally related.…”

Subjective sleep impairment in adults with type 1 or type 2 diabetes: Results from Diabetes MILES—The Netherlands

“…However, this small sample consisted of a highly select group of insulin-naive individuals who reported daytime sleepiness. Preliminary data in adults with type 2 diabetes suggest that sleep disturbances may also affect other aspects of daytime functioning, including daytime sleepiness, fatigue and mood [19][20][21][22]. However, these studies also had small sample sizes or focused on select groups only, i.e., adults from specialised clinics or participants in a randomised trial.…”

Avaliação da qualidade do sono e fatores associados em pacientes diabéticos tipo 2

“…Estudos realizados em outros países têm demonstrado alguns fatores associados ao sono de má qualidade em pacientes diabéticos como sexo feminino [4][5] , tempo de diagnóstico [6][7] , crises de hipoglicemia noturnas, nictúria 8 , ansiedade 9 , controle glicêmico [10][11][12][13] , apneia obstrutiva do sono 1,14 , depressão 5,[8][9] , índice de massa corporal, hábito de fumar e vida isolada 15 . Alguns poucos estudos realizados no Brasil pesquisaram a qualidade do sono em pacientes diabéticos 1,[16][17] . Pesquisas sobre o tema podem ser importantes fontes de informação para o planejamento adequado de estratégias específicas na promoção da qualidade do sono nesses pacientes.…”