Open AccessAssociation between sleep architecture and glucose tolerance in children and adolescents 儿童及青少年的睡眠结构与糖耐量的关系
Author(s) -
Zhu Yin,
Li Albert Martin,
Au Chun Ting,
Kong Alice Pik Shan,
Zhang Jihui,
Wong Chun Kwok,
Chan Juliana Chung Ngor,
Wing Yun Kwok
Publication year - 2015
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12138
Subject(s) - medicine , polysomnography , overweight , endocrinology , body mass index , sleep (system call) , insulin , glucose homeostasis , glucose tolerance test , sleep architecture , morning , sleep stages , obstructive sleep apnea , slow wave sleep , carbohydrate metabolism , insulin resistance , apnea , electroencephalography , computer science , operating system , psychiatry
Background Short sleep duration is a contributing factor for decreased insulin sensitivity and hyperglycemia. Sleep architecture represents a cyclical pattern of sleep that shifts between sleep Stages N1 , N2 , N3 (slow wave sleep) and Stage R (rapid eye movement sleep). The aim of the present study was to examine the association between sleep architecture and glucose and insulin metabolism in both normal weight and overweight/obese children and adolescents. Methods A total of 118 subjects participated in the study. Subjects underwent overnight polysomnography ( PSG ) when the percentage of total sleep time (% TST ) spent at each sleep stage was recorded and an oral glucose tolerance test together was performed the next morning. We assessed glucose tolerance, insulin sensitivity and pancreatic β‐cell function using 2‐h glucose levels, the Matsuda index ( IS OGTT ), and insulin secretion‐sensitivity index‐2 ( ISSI ‐2), respectively. Results After adjustment for age, gender, body mass index z ‐score, pubertal status, and obstructive apnea hypopnea index, Stage N3 (% TST ) was positively associated with IS OGTT , whereas Stage N1 (% TST ) exerted an opposite effect on IS OGTT . Higher sleep efficiency and longer TST were independently associated with lower 2‐h glucose levels, higher ISSI ‐2 and/or higher IS OGTT . Conclusions Stage N3 , sleep efficiency and TST were protective factors in maintaining glucose and insulin homeostasis; however, Stage N1 functioned in the opposite direction.