Characterization of abnormal sleep patterns in patients with obesity, type 2 diabetes, or combined

Abstract

Introduction: Obesity and type 2 diabetes mellitus have reached epidemic proportions worldwide. Abnormal sleep has been linked to both incident and prevalent obesity and type 2 diabetes. We aimed to characterize abnormal sleep patterns [ASP’s] in patients with obesity, type 2 diabetes, or both.

Subjects: The study included 92 subjects divided into four groups: Group 1, 23 obese patients (BMI > 30) with type 2 diabetes mellitus; Group 2, 23 non-obese diabetic patients; group 3, 23 obese subjects without diabetes; group 4, 23 matched healthy control subjects.

Methods: Waist circumference and BMI [body mass index] estimation, fasting and post challenge plasma glucose ‘‘groups 2 & 4”, HOMAIR [Homeostatic model assessment- Insulin resistance] estimation, and finally evaluation for ASP’s using a CDC [Centers for Disease Control and prevention] validated questionnaire.

Results: Post-prandial glucose and BMI significantly predicted Sleep latency and sleep hours at night respectively. Both group 1 and 3 compared to group 4 showed higher prevalence of: Insomnia [p < .01], snoring [p < .01], fragmented sleep [p < .05], excessive day time sleepiness [p < .001], and daytime dysfunction [p < .001]. Group 2 compared to group 4 showed higher prevalence of: Insomnia, snoring, fragmented sleep, and finally, daytime dysfunction [All p < .01]. Group 1 compared to groups 3 and 4 had significantly less hours of sleep at night [p < .01]. Group 1 compared to group 2 showed higher prevalence of: Insomnia, fragmented sleep, excessive day time sleepiness, and daytime dysfunction [All p < .05]. Finally, group 3 compared to group 2 showed higher prevalence of: Excessive day time sleepiness, and daytime dysfunction [p < .01].

Conclusion: The combination of obesity and diabetes mellitus is associated with poor quality and quantity of sleep with resultant significant daytime dysfunction. Glycemic, and adiposity measures predicted sleep latency and hours.

Keywords: Type 2 diabetes, Obesity, Abnormal sleep patterns, Insulin resistance Latency period, Impaired daily activities