Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes

  1. Pierre-Yves Benhamou, MD, PHD2
  1. 1Hypoxia Pathophysiology (HP2) Laboratory, Institut national de la santé et de la recherche médicale (INSERM) U1042, Joseph Fourier University, Grenoble, France
  2. 2Endocrinology Department, University Hospital, Grenoble, France
  3. 3CHU de Grenoble, Pole Locomotion, Rééducation & Physiologie, Clinique Physiologie, Sommeil et Exercice, Grenoble, France
  4. 4Cardiology Department, University Hospital, Grenoble, France
  1. Corresponding author: Anne-Laure Borel, alborel{at}chu-grenoble.fr.

Abstract

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.

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This Article

  1. Diabetes Care
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