Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes
- Anne-Laure Borel, MD, PHD1,2⇑,
- Jean-Louis Pépin, MD, PHD1,3,
- Laure Nasse, MSC2,
- Jean-Philippe Baguet, MD, PHD4,
- Sophie Netter, MD2 and
- Pierre-Yves Benhamou, MD, PHD2
- 1Hypoxia Pathophysiology (HP2) Laboratory, Institut national de la santé et de la recherche médicale (INSERM) U1042, Joseph Fourier University, Grenoble, France
- 2Endocrinology Department, University Hospital, Grenoble, France
- 3CHU de Grenoble, Pole Locomotion, Rééducation & Physiologie, Clinique Physiologie, Sommeil et Exercice, Grenoble, France
- 4Cardiology Department, University Hospital, Grenoble, France
- Corresponding author: Anne-Laure Borel, .
OBJECTIVE Sleep restriction has been associated with deteriorated insulin sensitivity. The effects of short sleep duration have been explored little in patients with type 1 diabetes. This study addresses the question of whether sleep curtailment affects HbA1c levels in patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS Seventy-nine adult patients with type 1 diabetes (median age 40 years [IQR 23–49]; 47% men) were recruited to wear a wrist actimetry sensor during 3 consecutive days to assess mean sleep duration during normal daily life. A subsample of 37 patients also performed a 24- h ambulatory blood pressure monitoring (ABPM). Medical history, sleep questionnaires, and diabetes-related quality of life (DQOL) were assessed.
RESULTS Patients having shorter sleep duration—less than 6.5 h (n = 21)—had higher levels of HbA1c (P = 0.01) than patients with longer sleep duration, above 6.5 h (n = 58). In a multivariable regression model including shorter versus longer sleep duration, diabetes duration, DQOL score, and daily activity, sleep duration was the only variable independently associated with HbA1c (R2 = 10%). In patients who performed 24-h ABPM, patients with a nondipping pattern of blood pressure exhibited shorter sleep duration than patients with a dipping pattern of blood pressure.
CONCLUSIONS Shorter sleep duration is associated with higher HbA1c levels in patients with type 1 diabetes, as well as with a nondipping pattern of blood pressure, anticipating a long-term deleterious impact on the risk of microvascular complications. Further studies should test whether extending the duration of sleep may improve both HbA1c and blood pressure in type 1 diabetes.
- Received October 6, 2012.
- Accepted April 1, 2013.
- © 2013 by the American Diabetes Association.
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