Sleep disturbances in diabetic peripheral neuropathy patients: a clinical and polysomnographic study

被引：9
作者：
Bahnasy W.S. [1 ,3 ]
El-Heneedy Y.A.E. [1 ]
El-Seidy E.A.S. [1 ]
Labib N.A.A. [1 ]
Ibrahim I.S.E. [2 ]
机构：
[1] Department of Neuropsychiatry, Tanta University, Tanta
[2] Department of Chest Diseases, Tanta University, Tanta
[3] Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta
来源：
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | / 54卷 / 1期
关键词：
Diabetic autonomic neuropathy; Diabetic peripheral neuropathy; Multiple sleep latency test and polysomnography; Sleep apnea syndrome;
D O I：
10.1186/s41983-018-0024-0
中图分类号：
学科分类号：
摘要：
Background: Disordered sleep breathing is a common complication of diabetic peripheral neuropathy (DPN) manifested by excessive daytime sleepiness, morning headache, morning dizziness, cognitive decline, and mood changes. Methods: This study was performed on 30 non-obese type 2 diabetic patients; 20 with clinically evident DPN and 10 without. Ten age-, sex-, and body mass index-matched healthy control subjects were also included. Patients and control were subjected to history taking, neurological examination, glycated hemoglobin, and clinical assessment of the sensori-motor manifestations by the neuropathy symptom score and neuropathy disability score. The autonomic nervous system was evaluated clinically by the systolic blood pressure response to standing and heart rate response to each of standing, Valsalva, and deep breath. Finally, sleep was assessed by one-night polysomnogram (PSG) followed by multiple sleep latency test in the next day. Results: The study showed significant increase in sleep apnea syndromes in diabetic peripheral neuropathy patients compared to diabetic neuropathy free patients and healthy control (p < 0.0001). The sleep apnea was mainly obstructive and to a little extent mixed (obstructive/central) sleep apnea. The severity of sleep PSG abnormalities was positively correlated with the severities of sensory, motor, and autonomic manifestations. Conclusions: Non-obese type 2 diabetic patients complicated by peripheral neuropathy especially those having dysautonomia are at increased risk of developing sleep disordered breathing resulting in their excessive daytime sleepiness, decreased productivity, and poor glycemic control. © 2018, The Author(s).
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  • [1] Aurora R.N., Punjabi N.M., Obstructive sleep apnoea and type 2 diabetes mellitus: a bidirectional association, Lancet Respir Med, 1, 4, pp. 329-338, (2013)
  • [2] Cabezas-Cerrato J., The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups. Neuropathy Spanish Study Group of the Spanish Diabetes Society, Diabetologia, 41, 11, pp. 1263-1269, (1998)
  • [3] Ceron E.M., Mateos R.C., Garcia-Rio F., Sleep apnea–hypopnea syndrome and type 2 diabetes. A reciprocal relationship, Arch Bronconeumol, 51, 3, pp. 128-139, (2015)
  • [4] Dimitropoulos G., Tahrani A.A., Stevens M.J., Cardiac autonomic neuropathy in patients with diabetes mellitus, World J Diabetes, 5, 1, pp. 17-39, (2014)
  • [5] Feldman E.L., Nave K.A., Jensen T.S., Bennett D.L.H., New Horizons in Diabetic Neuropathy: Mechanisms, Bioenergetics, and Pain, Neuron, 93, 6, pp. 1296-1313, (2017)
  • [6] Grigg-Damberger M.M., The AASM Scoring Manual four years later, J Clin Sleep Med, 8, 3, pp. 323-332, (2012)
  • [7] Kisozi T., Mutebi E., Kisekka M., Lhatoo S., Sajatovic M., Kaddumukasa M., Et al., Prevalence, severity and factors associated with peripheral neuropathy among newly diagnosed diabetic patients attending Mulago hospital: a cross-sectional study, Afr Health Sci, 17, 2, pp. 463-473, (2017)
  • [8] Littner M.R., Kushida C., Wise M., Davila D.G., Morgenthaler T., Lee Chiong T., Et al., Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test, Sleep, 28, 1, pp. 113-121, (2005)
  • [9] Martin C.L., Albers J.W., Pop-Busui R., Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study, Diabetes Care, 37, pp. 31-38, (2014)
  • [10] Meng L.L., Liu Y., Geng R.N., Tang Y.Z., Li D.Q., Association of diabetic vascular complications with poor sleep complaints, Diabetol Metab Syndr, 8, (2016)
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