Chronotherapeutic efficacy of suvorexant on sleep quality and metabolic parameters in patients with type 2 diabetes and insomnia

Yoshikawa, Fukumi; Shigiyama, Fumika; Ando, Yasuyo; Miyagi, Masahiko; Uchino, Hiroshi; Hirose, Takahisa; Kumashiro, Naoki

doi:10.1016/j.diabres.2020.108412

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…In one study, suvorexant, a selective orexin receptor antagonist, improved sleep quality and obesity-associated variables in people with type 2 diabetes ( n = 13) after 14 weeks [ 43 ]. In another study in 75 people with type 2 diabetes and insomnia receiving dexzopiclone or estazolam for 14 days, sleep was improved in both groups but only fasting glucose was significantly reduced in the dexzopiclone group.…”

Section: Treating Sleep Disorders In Type 2 Diabetesmentioning

confidence: 99%

Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature

et al. 2021

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Sleep disorders are linked to development of type 2 diabetes and increase the risk of developing diabetes complications. Treating sleep disorders might therefore play an important role in the prevention of diabetes progression. However, the detection and treatment of sleep disorders are not part of standardised care for people with type 2 diabetes. To highlight the importance of sleep disorders in people with type 2 diabetes, we provide a review of the literature on the prevalence of sleep disorders in type 2 diabetes and the association between sleep disorders and health outcomes, such as glycaemic control, microvascular and macrovascular complications, depression, mortality and quality of life. Additionally, we examine the extent to which treating sleep disorders in people with type 2 diabetes improves these health outcomes. We performed a literature search in PubMed from inception until January 2021, using search terms for sleep disorders, type 2 diabetes, prevalence, treatment and health outcomes. Both observational and experimental studies were included in the review. We found that insomnia (39% [95% CI 34, 44]), obstructive sleep apnoea (55–86%) and restless legs syndrome (8–45%) were more prevalent in people with type 2 diabetes, compared with the general population. No studies reported prevalence rates for circadian rhythm sleep–wake disorders, central disorders of hypersomnolence or parasomnias. Additionally, several cross-sectional and prospective studies showed that sleep disorders negatively affect health outcomes in at least one diabetes domain, especially glycaemic control. For example, insomnia is associated with increased HbA1c levels (2.51 mmol/mol [95% CI 1.1, 4.4]; 0.23% [95% CI 0.1, 0.4]). Finally, randomised controlled trials that investigate the effect of treating sleep disorders in people with type 2 diabetes are scarce, based on a small number of participants and sometimes inconclusive. Conventional therapies such as weight loss, sleep education and cognitive behavioural therapy seem to be effective in improving sleep and health outcomes in people with type 2 diabetes. We conclude that sleep disorders are highly prevalent in people with type 2 diabetes, negatively affecting health outcomes. Since treatment of the sleep disorder could prevent diabetes progression, efforts should be made to diagnose and treat sleep disorders in type 2 diabetes in order to ultimately improve health and therefore quality of life. Graphical abstract

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Section: Treating Sleep Disorders In Type 2 Diabetesmentioning

confidence: 99%

Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature

et al. 2021

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“…In T2DM mice, orexin antagonists provided chronotherapeutic effects against disturbances and improved glucose intolerance [ 168 , 169 ]. In patients with T2DM and insomnia, a selective orexin receptor antagonist not only improved sleep disorders but also provided metabolic benefits like abdominal circumference [ 170 ]. While controversial studies exist, some studies found that diabetic mice showed suppressed orexin expression [ 171 , 172 ], and orexin administration may have beneficial effects.…”

Section: Treatment For T2dm and Ad Targeting Circadian Rhythmsmentioning

confidence: 99%

A Growing Link between Circadian Rhythms, Type 2 Diabetes Mellitus and Alzheimer’s Disease

Peng

Fan

Xie

et al. 2022

IJMS

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Type 2 diabetes mellitus (T2DM) patients are at a higher risk of developing Alzheimer’s disease (AD). Mounting evidence suggests the emerging important role of circadian rhythms in many diseases. Circadian rhythm disruption is considered to contribute to both T2DM and AD. Here, we review the relationship among circadian rhythm disruption, T2DM and AD, and suggest that the occurrence and progression of T2DM and AD may in part be associated with circadian disruption. Then, we summarize the promising therapeutic strategies targeting circadian dysfunction for T2DM and AD, including pharmacological treatment such as melatonin, orexin, and circadian molecules, as well as non-pharmacological treatments like light therapy, feeding behavior, and exercise.

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“…This implies that respecting the pathophysiological principle of circadian BP variations represents a highly effective approach overwhelming the principle of BP smoothness maintenance. Moreover, chronotherapy may find its application in several other cardiovascular pathologies, such as resistant hypertension, 5 elevated heart rate (HR) in hypertension, 6 type 2 diabetes 7 and heart failure. 8 Importantly, this strategy is easy to introduce without an additional burden to the health care system.…”

mentioning

confidence: 99%

“… 12 Thus, preserving natural variations of cardiovascular gene expression via the tissue-local effect of RAAS inhibition may potentially result in more physiological vascular and myocardial remodelling, kidney damage attenuation or energetic metabolism improvement. 7 , 13 Moreover, chronotherapy may interfere with specific pharmacodynamic and pharmacokinetic characteristics of a particular substance facilitating haemodynamic and structural protection and reducing the adverse effects. 14 Hypothetically, some yet unknown mechanism of increased vascular wall and target organ sensitivity to inappropriate shear stress during the resting period could also participate.…”

mentioning

confidence: 99%

“…The plasma glucose level seems to undergo circadian changes relatively independent of external factors such as eating habits or medicines; 15 indeed, the chronotherapeutic approach in terms of increased sleep quality improved metabolic parameters in type 2 diabetic patients. 7 A systematic review of 25 studies revealed that circadian rhythmicity generates a pro-thrombotic state reflected by hypofibrinolysis and hypercolagulation in the morning hours potentially contributing to higher cardiovascular risk in the early period of the day. 16 On the contrary, although cholesterol biosynthesis undergoes circadian variations with the principal production in the night/morning hours, clinical trials did not show any benefit of chronotherapy versus conventional statin therapy for the treatment of hyperlipidaemia.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Chronotherapy of cardiovascular pathologies: a hopeful strategy

Šimko

Baka

2022

Therapeutic Advances in Chronic Disease

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Chronotherapeutic efficacy of suvorexant on sleep quality and metabolic parameters in patients with type 2 diabetes and insomnia

Cited by 8 publications

References 38 publications

Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature

Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature

A Growing Link between Circadian Rhythms, Type 2 Diabetes Mellitus and Alzheimer’s Disease

Chronotherapy of cardiovascular pathologies: a hopeful strategy

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