The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes

Saetung, Sunee; Nimitphong, Hataikarn; Siwasaranond, Nantaporn; Sumritsopak, Rungtip; Jindahra, Panitha; Krairit, Orapitchaya; Thakkinstian, Ammarin; Anothaisintawee, Thunyarat; Reutrakul, Sirimon

doi:10.1007/s00592-018-1166-3

Cited by 21 publications

(19 citation statements)

References 50 publications

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“…The finding is not driven by ethnic differences in severity of SDB or in treatment of SDB poststroke based on our previous work. 45 Synergistic effects between SDB and obesity on cognitive function have also been observed. For example, MAs may experience lower blood oxygen levels during sleep, greater reductions in sleep efficiency, greater reductions in slow wave or rapid eye movement sleep, or greater reduction in spindle activity, which may translate into poorer cognitive outcome.…”

Section: Discussionmentioning

confidence: 98%

“…For example, individuals with diabetes and low sleep efficiency have poorer cognitive function than those with higher sleep efficiency. 45 Synergistic effects between SDB and obesity on cognitive function have also been observed. 46 MAs with stroke have higher prevalence of both diabetes and obesity than NHWs.…”

Section: Discussionmentioning

confidence: 98%

“…Another possibility is synergistic effects of SDB and other risk factors for poor stroke outcome. For example, individuals with diabetes and low sleep efficiency have poorer cognitive function than those with higher sleep efficiency . Synergistic effects between SDB and obesity on cognitive function have also been observed .…”

Section: Discussionmentioning

confidence: 99%

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Sleep‐disordered breathing and poststroke outcomes

Lisabeth

Sánchez

Lim

et al. 2019

Annals of Neurology

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Objective: To examine the association between sleep-disordered breathing and stroke outcomes, and determine the contribution of sleep-disordered breathing to outcome disparities in Mexican Americans. Methods: Ischemic stroke patients (n = 995), identified from the population-based Brain Attack Surveillance in Corpus Christi Project (2010Project ( -2015, were offered participation in a sleep-disordered breathing study including a home sleep apnea test (ApneaLink Plus). Sleep-disordered breathing (respiratory event index ≥10) was determined soon after stroke. Neurologic, functional, cognitive, and quality of life outcomes were assessed at 90 days poststroke. Regression models were used to assess associations between sleep-disordered breathing and outcomes, adjusted for sociodemographics, prestroke function and cognition, health-risk behaviors, stroke severity, and vascular risk factors. Results: Median age was 67 years (interquartile range [IQR] = 59-78); 62.1% were Mexican American. Median respiratory event index was 14 (IQR = 6-25); 62.8% had sleep-disordered breathing. Sleep-disordered breathing was associated with worse functional outcome (mean difference in activities of daily living/instrumental activities of daily living score = 0.15, 95% confidence interval [CI] = 0.01-0.28) and cognitive outcome (mean difference in modified Mini-Mental State Examination = −2.66, 95% CI = −4.85 to −0.47) but not neurologic or quality of life outcomes. Sleep-disordered breathing accounted for 9 to 10% of ethnic differences in functional and cognitive outcome and was associated with cognitive outcome more strongly for Mexican Americans (β = −3.97, 95% CI = −6.63 to −1.31) than non-Hispanic whites (β = −0.40, 95% CI = −4.18 to 3.39, p-interaction = 0.15). Interpretation: Sleep-disordered breathing is associated with worse functional and cognitive function at 90 days poststroke. These outcomes are reasonable endpoints for future trials of sleep-disordered breathing treatment in stroke. If effective, sleep-disordered breathing treatment may somewhat lessen ethnic stroke outcome disparities.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

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Sleep‐disordered breathing and poststroke outcomes

Lisabeth

Sánchez

Lim

et al. 2019

Annals of Neurology

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“…Saetung et al examined the role of sleep in cognitive function of patients with abnormal glucose tolerance. 16 The study included 162 patients (81 type 2 diabetes and 81 prediabetes patients) and measured sleep duration (the amount of actual sleep obtained at night), sleep efficiency (percentage of time in bed spent sleeping), and obstructive sleep apnea using a portable diagnostic device. Cognitive function was assessed by the Thai version of the Montreal Cognitive Assessment.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Sleep disorders are common in patients with type 2 diabetes, 14 and a previous study reported the high prevalence of sleep dysfunction in patients with type 2 diabetes and demonstrated that a high proportion (69%) of type 2 diabetics had a Pittsburgh Sleep Quality Index score ≥ 5, suggesting reduced and disturbed sleep. 15 Although a cross-sectional study examined role of sleep in cognitive function of patients with prediabetes and type 2 diabetes, 16 the cross-sectional design could not determine the direction of causality in the associations and only examined cognitive function, not dementia. The role of sleep disorders in dementia incidence of patients with type 2 diabetes is unclear, and more data are needed.…”

Section: Introductionmentioning

confidence: 99%

Sleep disorders and risk of dementia in patients with new‐onset type 2 diabetes: A nationwide population‐based cohort study

Jin

Choi

2020

Journal of Diabetes

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Background: This study examined the relationship between sleep disorders and the risk of dementia in patients with newly diagnosed type 2 diabetes. Methods: This study used the Korean Health Screening Cohort data and included 39 135 subjects aged ≥40 years with new-onset type 2 diabetes between 2004 and 2007, with follow-up throughout 2013. Sleep disorders were measured by F51(sleep disorders not due to a substance or known physiological condition) or G47(sleep disorders) under International Classification of Diseases, Tenth Revision (ICD-10) codes as a primary diagnosis, and the adjusted hazard ratio (AHR) and 95% CI of all-cause dementia, Alzheimer disease, vascular dementia, and other dementia were estimated using multivariable Cox proportional hazards regression models. Results: In the patients with type 2 diabetes with an age range between 42 and 84 years (M = 57.8, SD = 9.5), this study identified 2059 events of dementia during an average follow-up time of 5.7 years. In patients with type 2 diabetes, subjects with sleep disorders were associated with an increased risk of all-cause dementia (AHR, 1.46; 95% CI, 1.19-1.80), Alzheimer disease (AHR, 1.39; 95% CI, 1.02-1.88), and other dementia (AHR, 1.69; 95% CI, 1.23-2.31) compared to those without sleep disorders. Men (AHR, 1.93; 95% CI, 1.42-2.62) and older adults (AHR, 1.70; 95% CI, 1.35-2.15) with sleep disorders were associated with an increased risk of dementia than their counterparts without sleep disorders among patients with type 2 diabetes. Conclusions: These findings suggest that sleep disorders are significantly associated with an increased risk of dementia in patients with new-onset type 2 diabetes.

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Comment to: The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes

Kawada

2018

Acta Diabetol

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The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes

Abstract: Lower sleep efficiency is independently associated with lower cognitive function in patients with abnormal glucose tolerance. Whether sleep optimization may improve cognitive function in these patients should be explored.

Cited by 21 publications

References 50 publications

Sleep‐disordered breathing and poststroke outcomes

Sleep‐disordered breathing and poststroke outcomes

Sleep disorders and risk of dementia in patients with new‐onset type 2 diabetes: A nationwide population‐based cohort study

Comment to: The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes

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