03610nas a2200493 4500008004100000022001400041245009600055210006900151260001300220300001100233490000700244520223400251653001002485653000902495653001802504653002602522653002802548653003002576653001202606653001102618653002702629653001102656653001402667653001202681653002302693653000902716653001602725653002602741653004702767653001202814653001802826100002402844700002402868700002102892700001802913700002202931700002402953700002102977700001902998700002103017700001803038700002403056856003603080 2015 eng d a1935-554800aSleep Disturbances and Glucose Metabolism in Older Adults: The Cardiovascular Health Study.0 aSleep Disturbances and Glucose Metabolism in Older Adults The Ca c2015 Nov a2050-80 v383 a
OBJECTIVE: We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults.
RESEARCH DESIGN AND METHODS: Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported SDB and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, from which insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. We determined the cross-sectional associations of sleep symptoms with fasting glucose levels, 2-h glucose levels, insulin sensitivity, and insulin secretion using generalized estimated equations and linear regression models. We determined the associations of updated and averaged sleep symptoms with incident diabetes in Cox proportional hazards models. We adjusted for sociodemographics, lifestyle factors, and medical history.
RESULTS: Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher 2-h glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea (hazard ratio [HR] 1.84 [95% CI 1.19-2.86]), snoring (HR 1.27 [95% CI 0.95-1.71]), and daytime sleepiness (HR 1.54 [95% CI 1.13-2.12]). In contrast, we did not find consistent associations between insomnia symptoms and glucose metabolism or incident type 2 diabetes.
CONCLUSIONS: Easily collected symptoms of SDB are strongly associated with insulin resistance and the incidence of type 2 diabetes in older adults. Monitoring glucose metabolism in such patients may prove useful in identifying candidates for lifestyle or pharmacological therapy. Further studies are needed to determine whether insomnia symptoms affect the risk of diabetes in younger adults.
10aAdult10aAged10aBlood Glucose10aCardiovascular System10aCross-Sectional Studies10aDiabetes Mellitus, Type 210aFasting10aFemale10aGlucose Tolerance Test10aHumans10aIncidence10aInsulin10aInsulin Resistance10aMale10aMiddle Aged10aSleep Apnea Syndromes10aSleep Initiation and Maintenance Disorders10aSnoring10aUnited States1 aStrand, Linn, Beate1 aCarnethon, Mercedes1 aBiggs, Mary, Lou1 aDjoussé, Luc1 aKaplan, Robert, C1 aSiscovick, David, S1 aRobbins, John, A1 aRedline, Susan1 aPatel, Sanjay, R1 aJanszky, Imre1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/6854