Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study

Abstract

Rationale and purpose Although sleep disorders are shown to be involved in occurrence of diabetes, impacts of several quantitative parameters related to sleep on insulin secretion and sensitivity is yet to be elucidated. We cross-sectionally examined relationships among quantitative sleep quality, sleep apnea, and autonomic function with insulin secretion and sensitivity in 399 patients without previous diagnosed diabetes who underwent 75-g oral glucose tolerance test (75gOGTT). Method Poor sleep quality (PSQ) was defined as an activity index ≥50 by actigraphy. Sleep apnea was measured by apnomonitor, while standard deviation of all normal-to-normal R-R intervals (SDNN) was measured by active tracer. Parameters of insulin secretion and sensitivity were measured by 75gOGTT. Results Patients with PSQ exhibited significantly lower insulinogenic index (r = 0.155, p < 0.01), a parameter of insulin secretion, with the association independent of other clinical factors including apnea and SDNN (β = −0.156, p < 0.01). In contrast, presence of sleep apnea (r = −0.143, p < 0.05) and the lower SDNN (r = −0.150, p < 0.01) were significantly and inversely associated with BIGTT-S, an insulin sensitivity parameter, with the association of SDNN with BIGTT-S remaining significant even after adjustments for PSQ and sleep apnea (β = −0.111, p < 0.05). Conclusion Poor sleep quality is an independent predictor of pancreatic β-cell function, which could be involved in occurrence of type 2 diabetes.

Reduction of Pressure Pain Sensitivity as Novel Non-pharmacological Therapeutic Approach to Type 2 Diabetes: A Randomized Trial

“…It is well known that ANSD is associated with obesity and sleep apnea ( Peterson et al, 1988 ; Kakutani-Hatayama et al, 2020 ), both closely linked to the development of T2D. The common denominator probably is the link between ANSD and insulin resistance as shown by Saito et al (2015) .…”

“…ANS dysfunction (ANSD), i.e., sympathetic predominance, is associated with the development of T2D, impaired glucose metabolic regulation, and poor outcome of T2D, including increased comorbidity (e.g., cardiovascular disease, renal insufficiency, and peripheral neuropathy) and increased mortality ( Vinik et al, 2013 ; Lundqvist et al, 2019 ; Spallone, 2019 ). Similarly, ANSD is linked to human obesity and excessive body fat, insulin resistance, and sleep apnea, all precursors of T2D ( Peterson et al, 1988 ; Saito et al, 2015 ; Kakutani-Hatayama et al, 2020 ).…”

Sleep and physical activity patterns in adults and children with Bardet–Biedl syndrome

“…People with BBS were found to have a lower total activity level than age-, sex-, and body mass index (BMI)-matched controls. Little is known about the benefits of sleep and physical activity in people with BBS, but in other populations adequate sleep and higher levels of physical activity and lower levels of sedentary time are associated with protection against weight gain [ 6 , 7 ] as well as a protective impact on negative health impacts of obesity [ 8 , 9 ].…”

Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase

“…To examine the presence of sleep apnea, we used an Apnomonitor (SAS-2100 ® , Teijin, Tokyo, Japan) to determine REI, as previously described 14 , 15 . An actigraphy device (Ambulatory Monitoring, Inc., Ardley, New York, USA), which senses motion as acceleration, was placed on the wrist of the non-dominant arm and used for quantitative analysis of sleep quality, as previously reported 16 – 19 . Actigraphy results have been shown to be as reliable as those obtained with polysomnography for determination of sleep disturbance 20 .…”