Introduction and Objective: Type 1 diabetes (DM1) is associated with poor sleep quality and increased prevalence of obstructive sleep apnea (OSA), leading to worse glycemic control. We aim to assess the impact of sleep disorders on cardio metabolic markers in DM1.Methods: Our retrospective cross-sectional study included patients with DM1 from our endocrinology clinic who underwent polysomnography (PSG). Sleep-related diagnoses were obtained from sleep clinic notes and PSG results, and were not mutually exclusive. For each sleep diagnosis, we created 2 subgroups, with and without the diagnosis. We calculated averages for metabolic markers and compared them between subgroups using two-sample one-tailed t-tests.Results: We included 45 patients (21 male and 24 female), average age of 52 years, total daily insulin dose (TDD) of 65 units, BMI of 32, systolic blood pressure (SBP) of 129 mmHg, A1C of 7.8%, LDL of 81, and triglycerides (TAG) of 117. The most common sleep diagnoses were OSA (n=29), insomnia (n=21), and periodic limb movement disorder (PLMD) (n=12). Patients with OSA had a higher A1C (M=8.1, SD=1.6 vs M=7.3, SD=1.1; p=0.043), SBP (M=133, SD=17 vs M=121, SD=11; p=0.006), and TAG (M=133, SD=100 vs M=82, SD=39; p=0.036) than those who did not. Patients with insomnia had a higher TAG (M=141, SD=121 vs M=96, SD=32; p=0.046) than those without it, but this difference disappeared after excluding OSA. Patients with PLMD used less daily insulin (M=43, SD=14 vs M=72, SD=40; p=0.009) and BMI (M=29, SD=4.9 vs M=34, SD=9.1; p=0.044) than those without it, though more patients with PLMD had OSA (83%) than those without PLMD (58%). With nested case-control analysis, this relationship remained significant for TDD (M=48, SD=15 vs M=65, SD=25; p=0.036).Conclusion: Patients with DM1 and OSA had poor metabolic health and glycemic control. In DM1 patients with insomnia, OSA was the driver of metabolic disturbances. PLMD was associated to lower BMI, even though OSA was more common.
F. Chagani: None. A.T.F. Kessler: None. A. Danyluk: None. K. Tuna: None. J.A. Leey: None.
National Institutes of Health (UL1TR001427)
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