Electrocardiogram-Based Sleep Spectrogram Measures of Sleep Stability and Glucose Disposal in Sleep Disordered Breathing

Pogach, Melanie; Punjabi, Naresh M.; Thomas, G. Neil; Thomas, Robert J.

doi:10.5665/sleep.1604

Cited by 20 publications

(9 citation statements)

References 40 publications

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“…Epidemiological studies support the experimental evidence. Number of arousals was closely associated with fasting insulin levels and insulin resistance even after adjustments for age and severity of adiposity in young adults [ 301 ] and EEG cues of wake/sleep transitions were associated with decreased insulin sensitivity and impaired insulin secretion independently of age, sex, body mass index, sleep stages, the arousal index, and the apnea-hypopnea index [ 305 ]. Importantly, it was observed that sleep fragmentation exerts a negative impact in subjects with clinically manifested diabetes, as suggested by a community-based study investigating middle-age adults assessing sleep using wrist actigraphy which demonstrated that sleep fragmentation was associated with higher fasting glucose and insulin levels as well as with reduced insulin sensitivity in patients with T2DM, but not in non-diabetics [ 56 ].…”

Section: Reviewmentioning

confidence: 99%

The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms

Briançon‐Marjollet

Weiszenstein

Henri

et al. 2015

Diabetol Metab Syndr

209

153

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Modern lifestyle has profoundly modified human sleep habits. Sleep duration has shortened over recent decades from 8 to 6.5 hours resulting in chronic sleep deprivation. Additionally, irregular sleep, shift work and travelling across time zones lead to disruption of circadian rhythms and asynchrony between the master hypothalamic clock and pacemakers in peripheral tissues. Furthermore, obstructive sleep apnea syndrome (OSA), which affects 4 - 15% of the population, is not only characterized by impaired sleep architecture but also by repetitive hemoglobin desaturations during sleep. Epidemiological studies have identified impaired sleep as an independent risk factor for all cause of-, as well as for cardiovascular, mortality/morbidity. More recently, sleep abnormalities were causally linked to impairments in glucose homeostasis, metabolic syndrome and Type 2 Diabetes Mellitus (T2DM). This review summarized current knowledge on the metabolic alterations associated with the most prevalent sleep disturbances, i.e. short sleep duration, shift work and OSA. We have focused on various endocrine and molecular mechanisms underlying the associations between inadequate sleep quality, quantity and timing with impaired glucose tolerance, insulin resistance and pancreatic β-cell dysfunction. Of these mechanisms, the role of the hypothalamic-pituitary-adrenal axis, circadian pacemakers in peripheral tissues, adipose tissue metabolism, sympathetic nervous system activation, oxidative stress and whole-body inflammation are discussed. Additionally, the impact of intermittent hypoxia and sleep fragmentation (key components of OSA) on intracellular signaling and metabolism in muscle, liver, fat and pancreas are also examined. In summary, this review provides endocrine and molecular explanations for the associations between common sleep disturbances and the pathogenesis of T2DM.

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Section: Reviewmentioning

confidence: 99%

The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms

Briançon‐Marjollet

Weiszenstein

Henri

et al. 2015

Diabetol Metab Syndr

209

153

View full text Add to dashboard Cite

show abstract

“…Furthermore, these associations remained significant even after adjustments for other clinical factors. These findings were rather unexpected, since sleep disordered breathing, a well-recognized cause of poor sleep quality, has been shown to be closely associated with insulin resistance [ 9 , 10 , 43 ]. In accordance with those reports, the present results also demonstrate that patients with sleep apnea with AHI greater than 5 exhibit significantly lower indices of insulin sensitivity, but not of insulin secretion, even though the significant association was lost after adjustment for other clinical factors.…”

Section: Discussionmentioning

confidence: 99%

Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study

et al. 2020

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Rationale and purpose Although sleep disorders are shown to be involved in occurrence of diabetes, impacts of several quantitative parameters related to sleep on insulin secretion and sensitivity is yet to be elucidated. We cross-sectionally examined relationships among quantitative sleep quality, sleep apnea, and autonomic function with insulin secretion and sensitivity in 399 patients without previous diagnosed diabetes who underwent 75-g oral glucose tolerance test (75gOGTT). Method Poor sleep quality (PSQ) was defined as an activity index ≥50 by actigraphy. Sleep apnea was measured by apnomonitor, while standard deviation of all normal-to-normal R-R intervals (SDNN) was measured by active tracer. Parameters of insulin secretion and sensitivity were measured by 75gOGTT. Results Patients with PSQ exhibited significantly lower insulinogenic index (r = 0.155, p < 0.01), a parameter of insulin secretion, with the association independent of other clinical factors including apnea and SDNN (β = −0.156, p < 0.01). In contrast, presence of sleep apnea (r = −0.143, p < 0.05) and the lower SDNN (r = −0.150, p < 0.01) were significantly and inversely associated with BIGTT-S, an insulin sensitivity parameter, with the association of SDNN with BIGTT-S remaining significant even after adjustments for PSQ and sleep apnea (β = −0.111, p < 0.05). Conclusion Poor sleep quality is an independent predictor of pancreatic β-cell function, which could be involved in occurrence of type 2 diabetes.

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“…CPC metrics were computed based on a time series of the normal-to-normal inter-beat intervals and corresponding ECG-derived respiratory signals. After Fourier transformation and outlier filtering, CPC ratios were computed by calculating the cross-spectral power and coherence with a widow size of 1024 points [15,19]. The spectrogram was classified into three primary frequency bands as follows: high-frequency coupling (HFC; 0.1-0.4 Hz), low-frequency coupling (LFC; 0.01-0.1 Hz), very low-frequency coupling (VLFC; 0.0039-0.01 Hz).…”

Section: Ltl Measurementmentioning

confidence: 99%

The association between leukocyte telomere lengths and sleep instability based on cardiopulmonary coupling analysis

et al. 2015

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Electrocardiogram-Based Sleep Spectrogram Measures of Sleep Stability and Glucose Disposal in Sleep Disordered Breathing

Abstract: ECG-derived sleep-spectrogram measures of sleep quality are associated with alterations in glucose-insulin homeostasis. This alternate mode of estimating sleep quality could improve our understanding of sleep and sleep-breathing effects on glucose metabolism.

Cited by 20 publications

References 40 publications

The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms

The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms

Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study

The association between leukocyte telomere lengths and sleep instability based on cardiopulmonary coupling analysis

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