Relationship between Sleep Disordered Breathing during Rapid Eye Movement Sleep and Coronary Risk Factors in Patients with Type 2 Diabetes Mellitus

Abstract

Sleep disordered breathing (SDB) is associated with hypertension, poor glycemic control and dyslipidemia. In general, apnea events are more prominent during rapid eye movement (REM) sleep than non-REM (NREM) sleep. Reportedly, only REM-AHI is associated with hypertension and HbA1c. We examined which SDB parameters are associated with BP, HbA1c and lipid profile in type 2 diabetes (T2D) patients. We analyzed 185 T2D patients who underwent polysomnography after excluding patients with pulmonary diseases, central sleep apnea, treated SDB or REM sleep < 30 minutes. We performed multiple linear regression analyses to predict BP, HbA1c and lipid profiles adjusted for known risk factors. Patients characteristics (mean±SD/median(IQR)): age 58.0 ± 11.8 yo, BMI 26.0 (24.1-28.9) kg/m2, systolic BP 134 ± 19.1 mmHg, mean BP 97.5 ± 13.8 mmHg, HbA1c 7.4 (6.8-8.4) %, TG 143 (97-195) mg/dL, non-HDL cholesterol 143 (120-163) mg/dL, REM-AHI 35.1 (21.1-53.1) /h. The analyses revealed REM-AHI was independently associated with systolic and mean BP whereas NREM-AHI was not (Fig. 1). No statistically significant association was observed between REM-AHI and HbA1c or lipid profile. REM-AHI was associated with systolic and mean BP in T2D patients. BP alteration associated with SDB during REM sleep may be an important pathophysiology linking between SDB and cardiovascular diseases. Disclosure T. Uchida: None. A. Nishimura: None. S. Kikuno: None. K. Nagasawa: None. M. Okubo: None. T. Kasai: None. K. Narui: None. Y. Mori: None.