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Altered sleep architecture in diabetes and prediabetes: findings from the Baependi Heart Study

2023; Oxford University Press; Volume: 47; Issue: 1 Linguagem: Inglês

10.1093/sleep/zsad229

1550-9109

Daniel M. Chen, Tâmara P. Taporoski, Shaina J. Alexandria, David Aaby, Felipe Beijamini, José Eduardo Krieger, Malcolm von Schantz, Alexandre C. Pereira, Kristen L. Knutson,

Sleep and related disorders

Abstract Study Objectives People with diabetes and prediabetes are more likely to have sleep-disordered breathing (SDB), but few studies examined sleep architecture in people with diabetes or prediabetes in the absence of moderate-severe SDB, which was the aim of our cross-sectional study. Methods This cross-sectional sample is from the Baependi Heart Study, a family-based cohort of adults in Brazil. About 1074 participants underwent at-home polysomnography (PSG). Diabetes was defined as fasting glucose >125 mg/dL or HbA1c > 6.4 mmol/mol or taking diabetic medication, and prediabetes was defined as HbA1c ≥ 5.7 & <6.5 mmol/mol or fasting glucose ≥ 100 & ≤125 mg/dl. We excluded participants with an apnea-hypopnea index (AHI) ≥ 30 in primary analyses and ≥ 15 in secondary analysis. We compared sleep stages among the 3 diabetes groups (prediabetes, diabetes, neither). Results Compared to those without diabetes, we found shorter REM duration for participants with diabetes (−6.7 min, 95%CI −13.2, −0.1) and prediabetes (−5.9 min, 95%CI −10.5, −1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (−13.7 min, 95%CI −26.8, −0.6), longer slow-wave sleep (N3) duration (+7.6 min, 95%CI 0.6, 14.6) and higher N3 percentage (+2.4%, 95%CI 0.6, 4.2), compared to those without diabetes. Results were similar when restricting to AHI < 15. Conclusions People with diabetes and prediabetes had less REM sleep than people without either condition. People with diabetes also had more N3 sleep. These results suggest that diabetes and prediabetes are associated with differences in sleep architecture, even in the absence of moderate-severe sleep apnea.