Sleep Disturbances Are Associated with Poorer Glycemia and Increased Obesity in Youth at Risk for or with Early Type 2 Diabetes (T2D)

Abstract

Poor sleep may be associated with an increased risk of obesity and T2D in youth. We explored whether subjective sleep duration, sleep quality or risk factors for obstructive sleep apnea (OSA) are associated with BMI, glycemia or blood pressure (BP) in youth. Between 2013 and 2016, 236 overweight and obese youth (10-19 years old) at risk for or with recently diagnosed T2D were screened for the Restoring Insulin Secretion (RISE) Study. Data from a 2 hour OGTT and validated Sleep Disturbances Scale and Cleveland Adolescent Sleepiness questionnaires were available for 214 youth. Regression models explored the independent association between sleep variables and outcomes of fasting glucose, 2-h glucose, HbA1c, BMI and BP. The cohort consisted of 67% females, 33% males; 26% white, 26% black, 33% hispanic; age 14.1±2.1 years and BMI 35.9±6.5 kg/m2 (mean±SD). Based on the ADA criteria, 20% had normal glucose tolerance, 60% had prediabetes and 20% had T2D. Sleep duration <8 h and <7 h was reported in 74% and 43% respectively; 51% reported daytime sleepiness; 26% reported poor sleep quality, and 30% high risk for OSA. 28% of the cohort was on metformin. After adjusting for age, sex, race/ethnicity, BMI and metformin use, the presence of daytime sleepiness was associated with 0.19% higher HbA1c (p=0.018) and higher 2-h glucose (13.3 mg/dl, p=0.05), but sleep duration, quality, and OSA risk were not associated with any of the outcomes. After adjusting for age, sex, race/ethnicity and metformin use, poor sleep quality was associated with 2.95 kg/m2 higher BMI (p=0.003), and high OSA risk with 2.81 kg/m2 higher BMI (p<0.003). In these overweight and obese youth with or at risk for T2D, daytime sleepiness was associated with poorer glycemia, while poor sleep quality and high OSA risk were associated with higher BMI. These findings suggest that intervention studies aimed at improving sleep in youth are required to determine potential benefits on glycemia and weight. Disclosure B. Mokhlesi: None. K.A. Temple: None. A.N. Hogan: None. S. Edelstein: None. K.J. Nadeau: None. S. Sam: None. T. Hannon: Consultant; Self; Eli Lilly and Company. K. Utzschneider: Consultant; Self; Novo Nordisk Inc.. E. Barengolts: None. S. Manchanda: None. D.A. Ehrmann: None. E. Van Cauter: Research Support; Self; AstraZeneca. R. Consortium: None.