Abstract
The aim of this study was to determine the relationship between sleep condition and autonomic nervous function of women in their 70s with type 2 diabetes mellitus by analyzing the activity counts (AC) on actigraphs and heart rate variability (HRV). Ten healthy women in their 30s to 40s as control and four women patients with type 2 diabetes in their 70s wore the electrocardiograph and an actigraph for 24 hours while keeping a diary of activities, including their sleep and food intake. The Pittsburgh Sleep Quality Index was used to assess subjective sleep conditions. The subjective sleeping results were significantly correlated with those measured by the AC and HRV. However, AC and HRV correlation pattern showed different activity in the patients with type 2 diabetes mellitus. The quality of sleep of those with chronic diabetes was not good even if their HbA1c was well controlled. Furthermore, their automatic nervous function was different from the control group. The sleeping hours of patients with type 2 diabetes were shorter or longer than those of healthy women. Ultimately, this study maintains that it is important to examine automatic nervous functions using objective examination index during the early stage of diabetes mellitus.
Highlights
Recent epidemiological, biological, and behavioral evidence suggests that sleep disorders may contribute to the development of diabetes; diabetes itself may contribute to sleep disorders [1]
The HbA1c level of Case A in her 70s was controlled by the exercise and diet plan she received while visiting the hospital (HbA1c 6.0%), with a tendency to show the same correlations between the activity counts (AC) and high frequency (HF) and between the AC and low frequency (LF)/HF as in healthy women
The AC and heart rate variability (HRV) were almost precisely correlated, and parasympathetic and sympathetic nervous functions were balanced in healthy women in their 20s to 40s
Summary
Biological, and behavioral evidence suggests that sleep disorders may contribute to the development of diabetes; diabetes itself may contribute to sleep disorders [1]. The mortality rates of individuals with diabetes, high-blood pressure, or a sleep disturbance are high [2,3], and sleep disturbances notably increase blood glucose levels and blood pressure [4,5]. The highest risk of diabetes has been found in individuals with insomnia and ≤5 hours sleep duration group (odds ratio [95% CI] 2.95 [1.2 - 7.0]). Insomnia with short sleep duration is associated with increased odds of diabetes. Objective sleep duration may predict the cardio metabolic morbidity of chronic insomnia [7]. Sleep apnea increases the risk of developing diabetes, independent of other risk factors. Among patients with more severe sleep apnea, regular positive airway pressure use may attenuate this risk [8]
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