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. 2019 Dec;20(8):1056-1063.
doi: 10.1111/pedi.12917. Epub 2019 Sep 15.

The association of sleep disturbances with glycemia and obesity in youth at risk for or with recently diagnosed type 2 diabetes

Babak Mokhlesi  1 , Karla A Temple  1 , Ashley H Tjaden  2 , Sharon L Edelstein  2 , Kristen J Nadeau  3 , Tamara S Hannon  4 , Shalini Manchanda  4 , Susan Sam  1 , Elena Barengolts  5 , Kristina M Utzschneider  6 , David A Ehrmann  1 , Eve Van Cauter  1 ; RISE Consortium
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The association of sleep disturbances with glycemia and obesity in youth at risk for or with recently diagnosed type 2 diabetes

Babak Mokhlesi et al. Pediatr Diabetes. 2019 Dec.

Abstract

Objective: Poor sleep may increase obesity and type 2 diabetes (T2D) risk in youth. We explored whether subjective sleep duration, sleep quality, or risk for obstructive sleep apnea (OSA) are associated with glycemia, body mass index (BMI), or blood pressure (BP) in overweight/obese youth.

Methods: Two-hundred and fourteen overweight/obese youth of 10 to 19 years of age at risk for or recently diagnosed with T2D who were screened for the Restoring Insulin Secretion (RISE) Study had a 2-hour oral glucose tolerance test (OGTT) and completed a Cleveland Adolescent Sleepiness questionnaire and a Sleep Disturbances Scale questionnaire. Independent associations between sleep variables and measures of glycemia, BMI, and BP were evaluated with regression models.

Results: The multiethnic cohort was 67% female, 14.1 ± 2.1 years, and BMI 35.9 ± 6.5 kg/m2 . Habitual sleep duration <8 hours was reported in 74%. Daytime sleepiness was reported in 51%, poor sleep quality in 26%, and 30% had high obstructive sleep apnea (OSA) risk. Daytime sleepiness was associated with higher HbA1c (0.2%, P = .02) and 2-hour glucose (13.6 mg/dL, P < .05). Sleep duration, sleep quality, and OSA risk were not associated with the evaluated outcomes. Poor sleep quality and OSA risk were associated with higher BMI (2.9 kg/m2 , P = .004 and 2.83 kg/m2 , P < .003, respectively).

Conclusions: In overweight/obese youth with or at risk for T2D, daytime sleepiness was associated with higher HbA1c. In addition, poor sleep quality and OSA risk were associated with higher BMI. These findings support intervention studies aimed at improving sleep quality in obese youth.

Keywords: adolescents; children; glucose; glycemia; hemoglobin A1c; hypersomnolence; hypertension; obesity; sleep apnea; sleep duration; sleep quality; sleepiness.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Association between self-reported sleep measures and outcomes. Adjusted means from analysis of covariance (ANCOVA) models. Data shown are adjusted means and 95% confidence intervals. Quality is sleep quality, sleepiness is daytime sleepiness, and duration is sleep duration. Models adjusted for age, sex, race/ethnicity, metformin use, and Tanner stage. HbA1c, fasting glucose, 2-hour glucose, and blood pressure models were also adjusted for BMI. *ANCOVA P < .05
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