Abstract
BackgroundRecent epidemiological and experimental data suggest a negative influence of shortened or disturbed night sleep on glucose tolerance. Due to the high prevalence of sleep disorders this might be a major health issue. However, no comparative studies of carbohydrate metabolism have been conducted in clinical sleep disorders.Methodology/Principal FindingsWe performed oral glucose tolerance tests (OGTT) and assessed additional parameters of carbohydrate metabolism in patients suffering from obstructive sleep apnea syndrome (OSAS, N = 25), restless legs syndrome (RLS, N = 18) or primary insomnia (N = 21), and in healthy controls (N = 33). Compared to controls, increased rates of impaired glucose tolerance were found in OSAS (OR: 4.9) and RLS (OR: 4.7) patients, but not in primary insomnia patients (OR: 1.6). In addition, HbA1c values were significantly increased in the same two patient groups. Significant positive correlations were found between 2-h plasma glucose values measured during the OGTT and the apnea-arousal-index in OSAS (r = 0.56; p<0.05) and the periodic leg movement-arousal-index in RLS (r = 0.56, p<0.05), respectively. Sleep duration and other quantitative aspects of sleep were similar between patient groups.Conclusions/SignificanceOur findings suggest that some, but not all sleep disorders considerably compromise glucose metabolism. Repeated arousals during sleep might be a pivotal causative factor deserving further experimental investigations to reveal potential novel targets for the prevention of metabolic diseases.
Highlights
Obesity and diabetes are closely linked medical conditions, which, to a great extent, account for long-term morbidity and mortality worldwide [1,2]
Conclusions/Significance: Our findings suggest that some, but not all sleep disorders considerably compromise glucose metabolism
obstructive sleep apnea syndrome (OSAS) patients had a strongly increased BMI, whereas the BMI of restless legs syndrome (RLS) and insomnia patients did not differ from controls
Summary
Obesity and diabetes are closely linked medical conditions, which, to a great extent, account for long-term morbidity and mortality worldwide [1,2]. According to recent epidemiological evidence, both obesity and diabetes are related to chronic short sleep duration [3]. In healthy people even short-term sleep restriction or experimentally induced disturbed sleep have been shown to impair glucose tolerance [4,5] indicating that sleep might be pivotal for metabolic homeostasis. Tentative evidence suggests that the obstructive sleep apnea syndrome (OSAS) might be a risk factor for diabetes regardless of concomitant obesity [6]. In OSAS it cannot be determined whether impaired glucose tolerance is due to repeated nocturnal oxygen desaturation or due to disturbed sleep per se. Recent epidemiological and experimental data suggest a negative influence of shortened or disturbed night sleep on glucose tolerance. No comparative studies of carbohydrate metabolism have been conducted in clinical sleep disorders
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