Relationship between obstructive sleep apnoea during rapid eye movement sleep and metabolic syndrome parameters in patients with type 2 diabetes mellitus

Abstract

Purpose

Sleep-disordered breathing (SDB) is associated with hypertension, poor glycemic control and dyslipidemia. Usually, apnoea events tend to be more prominent during rapid eye movement (REM) sleep than non-REM (NREM) sleep. We examined which SDB parameters are associated with blood pressure (BP), HbA1c and lipid profile in patients with type 2 diabetes (T2D).

Methods

A total of 185 patients with T2D who underwent polysomnography were analysed. Exclusion criteria were: the presence of pulmonary diseases, central sleep apnoea, treated SDB, or REM sleep < 30 min. To predict BP, HbA1c, and lipid profiles, we performed multiple linear regression analyses adjusted for known risk factors. Subsequently, we performed multivariable logistic regression analyses.

Results

Patient characteristics (mean ± standard deviation/median) were as follows: age 58.0 ± 11.8 years, body mass index 26.0 kg/m2 (24.1–28.9 kg/m2 ), systolic BP 134 ± 19 mmHg, mean BP 98 ± 14 mmHg, HbA1c 7.4% (6.8–8.4%), triglyceride 143 mg/dL (97–195 mg/dL), non-high density lipoprotein (non-HDL) cholesterol 143 mg/dL (120–163 mg/dL), REM-apnoea–hypopnea index (AHI) 35.1/h (21.1–53.1/h). The analyses revealed that REM-AHI was independently associated with systolic and mean BP, whereas NREM-AHI was not. A statistically significant association was not observed between REM-AHI and HbA1c or lipid profile.

Conclusion

In patients with T2D, REM-AHI was associated with systolic and mean BP. The alteration of BP, associated with SDB during REM sleep, may be an important pathophysiological link between SDB and cardiovascular diseases.

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Fig. 1

Data availability

The data were collected by the authors in Toranomon Hospital.

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Acknowledgements

We thank Fumie Takano for her work of data collection.

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Correspondence to Akihiro Nishimura.

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The institutional review board of Toranomon Hospital approved the study protocol.

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Dr. SPSS II for Windows (SPSS Japan Inc., Tokyo, Japan).

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Uchida, T., Nishimura, A., Kasai, T. et al. Relationship between obstructive sleep apnoea during rapid eye movement sleep and metabolic syndrome parameters in patients with type 2 diabetes mellitus. Sleep Breath (2020). https://doi.org/10.1007/s11325-020-02129-7

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Keywords

  • Diabetes mellitus, type 2
  • Sleep apnoea syndromes
  • Sleep, REM
  • Hypertension