The relationship between sleep quality and diabetic autonomic neuropathy in elder patients with type 2 diabetes mellitus

Abstract

To explore the relationship between the sleep quality and diabetic autonomic neuropathy of elder patients with type 2 diabetes mellitus. A total of 90 elder patients with diabetes in Beijing Hospital was enrolled in this study. Questionnaires of Pittsburgh Sleep Quality Index(PSQI) were completed to evaluate the quality of sleep and Holter was applied to evaluate heart rate variability (HRV). Other related clinical data such as, catecholamine[epinephrine(E); norepinephrine(NE); dopamine(DA)]and diabetes complications were also collected after admission to the hospital. Patients were divided into three groups: the poor-sleeper group, the common-sleeper group and the good-sleeper group according to PSQI score. HRV and the level of catecholamine were compared among three groups. The level of HRV including meanNN [(743 ± 58) ms vs(824 ± 99)ms and (837 ± 104)ms], ASDNN [(30 ± 10)ms vs (39 ± 14)ms and (41 ± 14)ms], very low frequency(VLF)[(15.33 ± 6.10)ms(2) vs(22.11 ± 7.94)ms(2) and (22.66 ± 7.87)ms(2)], low frequency (LF)[(8.30 ± 3.95) ms(2) vs(12.58 ± 6.11)ms(2) and(12.81 ± 6.96)ms(2)] and LF/high frequency(HF)[(1.23 ± 0.32) vs (1.56 ± 0.46) and (1.47 ± 0.42)] in the poor-sleeper group were lower than in both the common-sleeper group and good-sleeper group (all P<0.05). The level of catecholamine in poor-sleeper group [E: (108.91 ± 4.19)ng/L; NE: (1458.0 ± 50.35)ng/L] were lower than both the common-sleeper group [E: (120.23 ± 4.37) ng/L; NE: (1901.09 ± 131.36)ng/L] and the good-sleeper group [E: (118.23 ± 19.9)ng/L; NE: (1771.87 ± 116.73)ng/L] (all P<0.05), suggesting a dysfunction in autonomic nervous system in subject in the poor-sleeper group. Sleep quality is associated with the severity of diabetic autonomic neuropathy and might be one of clinical features for diabetic autonomic neuropathy.