|Title||Diabetes and sleep disturbances: findings from the Sleep Heart Health Study.|
|Publication Type||Journal Article|
|Year of Publication||2003|
|Authors||Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, Ewy GA, Howard BV, Punjabi NM|
|Corporate Authors||Sleep Heart Health Study|
|Date Published||2003 Mar|
|Keywords||Aged, Diabetes Mellitus, Female, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, Risk Factors, Sleep Apnea Syndromes, Sleep Apnea, Obstructive|
OBJECTIVE: To test the hypothesis that diabetes is independently associated with sleep-disordered breathing (SDB), and in particular that diabetes is associated with sleep abnormalities of a central, rather than obstructive, nature.
RESEARCH DESIGN AND METHODS: Using baseline data from the Sleep Heart Health Study (SHHS), we related diabetes to 1). the respiratory disturbance index (RDI; number of apneas plus hypopneas per h of sleep); 2). obstructive apnea index (OAI; >or=3 apneas/h of sleep associated with obstruction of the upper airway); 3). percent of sleep time or=3 apneas [without respiratory effort]/h sleep); 5). occurrence of a periodic breathing (Cheyne Stokes) pattern; and 6) sleep stages. Initial analyses excluding persons with prevalent cardiovascular disease (CVD) were repeated including these participants.
RESULTS: Of the 5874 participants included in this report, 692 (11.8%) reported diabetes or were taking oral hypoglycemic medications or insulin and 1002 had prevalent CVD. Among the 4872 persons without CVD, 470 (9.6%) had diabetes. Diabetic participants had worse CVD risk factor profiles than their nondiabetic counterparts, including higher BMI, waist and neck circumferences, triglycerides, higher prevalence of hypertension, and lower HDL cholesterol (P
CONCLUSIONS: These data suggest that diabetes is associated with periodic breathing, a respiratory abnormality associated with abnormalities in the central control of ventilation. Some sleep disturbances may result from diabetes through the deleterious effects of diabetes on central control of respiration. The high prevalence of SDB in diabetes, although largely explained by obesity and other confounders, suggests the presence of a potentially treatable risk factor for CVD in the diabetic population.
|Alternate Journal||Diabetes Care|
|Grant List||U01HL53916 / HL / NHLBI NIH HHS / United States |
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53934 / HL / NHLBI NIH HHS / United States
U01HL53937 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U01HL63429 / HL / NHLBI NIH HHS / United States
U01HL63463 / HL / NHLBI NIH HHS / United States
U01HL64360 / HL / NHLBI NIH HHS / United States