Abstract
PurposeGlycemic variability (GV) and hypoglycemia during nighttime are presumed to be associated with fatal bradycardia. The aim of this prospective study was to evaluate blood glucose dynamics during sleep in patients with obstructive sleep apnea syndrome (OSA) and normal glucose tolerance.MethodsPatients with OSA and no diabetes who underwent type 1 overnight polysomnography from December 2018 to May 2020 participated in this study. GV was evaluated in all participants for 14 days using a flash glucose monitoring device. Correlations were examined between GV indexes and indexes related to sleep breathing disorders, the effects of treatment with continuous positive airway pressure (CPAP) on these GV indexes, and the characteristics of glucose dynamics in different OSA subtypes classified by sleep stage.ResultsAmong 42 patients with OSA and no diabetes, the standard deviation of GV during sleep correlated significantly with sleep time spent with oxygen saturation <90% (r=0.591, p=0.008). High blood glucose index during sleep correlated significantly with stage N1% (r=0.491, p=0.032) and negatively with stage N2% (r=−0.479, p=0.038). High blood glucose index correlated significantly with sleep time spent with oxygen saturation <90% (r=0.640, p=0.003). The rapid eye movement–related OSA group had a higher incidence of hypoglycemia. One-week with CPAP treatment significantly improved GV during sleep, standard deviation of GV (from 12.1 to 9.0 mg/dL, p<0.001), and high blood glucose index (from 0.7 to 0.4, p=0.006).ConclusionsTo evaluate GV during sleep in patients with OSA may be useful for clinical risk management. CPAP treatment for 1 week may have an improving GV and high blood glucose index.Clinical trial registrationUMIN000038489 2019/11/04, UMIN 000025433 2016/12/27
Highlights
Presentation at a conferenceThis manuscript has not been published or presented at a conference elsewhere in part or in entirety and is not under consideration by another journal.In patients with obstructive sleep apnea (OSA) syndrome, progression of arteriosclerosis is enhanced by increased sympathetic nerve activity associated with nocturnal awakening and sleep fragmentation [1], vascular endothelial dysfunction via inflammation and oxidative stress associated with intermittent hypoxia [2], and increased arterial stiffness [3]
We have previously reported that Glycemic variability (GV), hyperglycemia, and hypoglycemia are probably involved in the pathophysiology of vascular endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM) [11]
Our study demonstrated significantly greater GV, evidenced by nocturnal values of standard deviation (SD), coefficient of variation (CV), TIR, and high blood glucose index (HBGI), in patients with obstructive sleep apnea syndrome (OSA) and normal glucose tolerance, compared with healthy individuals
Summary
Presentation at a conferenceThis manuscript has not been published or presented at a conference elsewhere in part or in entirety and is not under consideration by another journal.In patients with obstructive sleep apnea (OSA) syndrome, progression of arteriosclerosis is enhanced by increased sympathetic nerve activity associated with nocturnal awakening and sleep fragmentation [1], vascular endothelial dysfunction via inflammation and oxidative stress associated with intermittent hypoxia [2], and increased arterial stiffness [3]. In type 2 diabetes mellitus (T2DM), increased glycemic variability (GV) is considered to play a part in the onset and progression of macroangiopathy [4], and GV has been linked to the risk of death associated with cardiovascular events [5]. We have previously reported that GV, hyperglycemia, and hypoglycemia are probably involved in the pathophysiology of vascular endothelial dysfunction in patients with T2DM [11]. In this regard, latest advances in T2DM treatment suggest the need for more than just the monitoring of average blood glucose level using glycated hemoglobin (HbA1c) values and call for highquality glycemic control with minimal GV
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
