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Objective Sleep Characteristics and Continuous Glucose Monitoring Profiles of Type 2 Diabetes Patients in Real-Life Settings
26 Pages Posted: 25 Aug 2022
More...Abstract
Background: Given the significant role of sleep in glycemic control, the association between sleep and glycemic variability determined by continuous glucose monitoring (CGM) is worth investigating among patients with type 2 diabetes (T2D).
Methods: CGM was carried out among 28 T2D patients (aged 62.3±4.8 years, 57% women). Sleep characteristics were assessed by actigraphy within the CGM period. CGM-derived outcomes included glucose level, percentages of time in range (TIR) and time above range (TAR) during the monitoring period. Associations between intraindividual night-to-night variations of sleep characteristics and overall CGM outcomes were analyzed by linear regression. Associations between sleep characteristics in each night and time-matched CGM outcomes were analyzed by linear mixed models.
Results: A total 249 person-days of CGM coupled with 221 nights of sleep characteristics were documented. Greater standard deviation (SD) of objective sleep duration (minutes) between measurement nights was associated with higher glucose level (mmol/L, Coefficient [95% CI]: 0.018 [0.004, 0.033], P=0.017), smaller proportion of TIR (% in observation period, -0.20 [-0.36, -0.03], P=0.023), and greater proportion of TAR (0.22 [0.06, 0.39], P=0.011). Later sleep midpoint (minutes from 00:00) was associated with greater SD of glucose during the same sleep period (0.002 [0.0001, 0.003], P=0.037), longer nocturnal sleep duration was associated with smaller coefficient of variance of glucose level in the upcoming day (%, -0.015 [-0.03, -0.001], P=0.041).
Conclusion: Objectively-determined sleep duration and sleep midpoint, as well as their daily variability, are associated with CGM-derived glucose profiles in T2D patients.
Funding Information: This research was supported by Sport and Health Project, Jiangsu Collaborative Innovation Center (Y.Z., JSCIC-GP21007), Swedish Medical Research Society (X.T. P18-0084), Åke Wiberg Foundation (X.T., M18-0169, M19-0266), Fredrik and Ingrid Thuring Foundation (X.T., 2019-00488), Key Research and Development Program in Jiangsu Province (Y.Z., BE2022828), and Kinesiology Laboratory Research Project, Nanjing Sport Institute (Y.Z. SYS202105).
Declaration of Interests: No conflict of interest to disclose.
Ethics Approval Statement: The study protocol was approved by the ethics committee of the Affiliated Rehabilitation Hospital of Nanjing Sport Institute in accordance with the principles of the Declaration of Helsinki. Participation was voluntary, written consent form was obtained from each participant prior to the measurements.
Keywords: continuous glucose monitoring, sleep, chronotype, daily variability, type 2 diabetes
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