Sleep disordered breathing in REM sleep reverses the downward trend in glucose concentration

Abstract Objective Regulation of glucose concentration depends on sleep stages with interstitial glucose concentration (IGC) declining in REM vs. stable IGC in NREM sleep. Apneas and hypopneas constituting sleep disordered breathing (SDB) are implicated in impaired glucose metabolism. Therefore, the...

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Bibliographic Details
Published in:Sleep medicine 2011-01, Vol.12 (1), p.76-82
Main Authors: Bialasiewicz, Piotr, Czupryniak, Leszek, Pawlowski, Maciej, Nowak, Dariusz
Format: Article
Language:English
Subjects:
Adult
Blood glucose
Blood Glucose - analysis
Blood Glucose - physiology
Continuous glucose monitoring
Female
Hemoglobins - analysis
Hemoglobins - physiology
Humans
Male
Middle Aged
Neurology
Polysomnography
REM sleep
Sleep - physiology
Sleep apnea
Sleep Apnea Syndromes - blood
Sleep Apnea Syndromes - physiopathology
Sleep disordered breathing
Sleep Medicine
Sleep, REM - physiology
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Summary:Abstract Objective Regulation of glucose concentration depends on sleep stages with interstitial glucose concentration (IGC) declining in REM vs. stable IGC in NREM sleep. Apneas and hypopneas constituting sleep disordered breathing (SDB) are implicated in impaired glucose metabolism. Therefore, the aim of the study was to investigate whether SDB can influence IGC in REM and NREM sleep. Methods Thirty-two patients underwent standard polysomnography with continuous glucose monitoring system (CGMS) and a morning fasting glucose measurement. Eleven subjects were eligible due to the periodic occurrence of SDB in sleep; thus the presence of REM and NREM sleep with and without SDB (REM-, NREM-no-SDB and REM-, NREM-SDB, respectively). Results The IGC in REM-no-SDB declined, and its mean change was lower than that of NREM-no-SDB by almost 10-fold: −0.047 ± 0.051 vs. −0.005 ± 0.022 mmol/l·5 min−1 , respectively ( P = 0.019, n = 11). The occurrence of SDB in REM abolished this decline: 0.002 ± 0.022 vs. −0.053 ± 0.049 mmol/l·5 min−1 for REM-no-SDB ( P = 0.006; n = 10). There was no difference between NREM-no-SDB and NREM-SDB in respect to IGC. Conclusion Occurrence of SDB in REM reversed the decline of IGC, while in NREM sleep SDB had no effect on IGC. SDB may affect neuro-endocrine regulations in REM sleep.
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2010.04.017