Diabetes, Metabolic Syndrome and Obesity (Nov 2022)
Sleep and Circadian Rhythm Disturbances in Diabetes: A Narrative Review
Abstract
Femke Rutters,1,2 Giesje Nefs3– 5 1Department of Epidemiology and Data Science, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands; 2Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; 3Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; 4Diabeter, Center for Type 1 Diabetes Care and Research, Rotterdam, the Netherlands; 5Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, the NetherlandsCorrespondence: Femke Rutters, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, De Boelelaan 1089a, 1081 HV, Amsterdam, Noord-Holland, the Netherlands, Tel +31 20 4445860, Email [email protected]: Sleep and circadian rhythm disturbances are less-known risk factors for the development and suboptimal outcomes of diabetes. The goal of this narrative review is to highlight the importance of sleep and circadian rhythm disturbances in the development and outcomes of type 1 diabetes (T1D) and type 2 diabetes (T2D), assess current treatment options and the possible mediating mechanisms. We performed a literature search using PubMed and selected relevant English and Dutch papers. Disturbances of sleep and circadian rhythm are common in people with diabetes. They are associated with an increased risk of developing T2D as well as with suboptimal diabetes outcomes (including higher HbA1c levels and reduced quality of life) for T1D and T2D. Preliminary data suggest that treatment of sleep and circadian rhythm disturbances could improve diabetes outcomes in people with T1D and T2D. Finally, the association with medical parameters appears to be mediated by disturbance in hormones, and by suboptimal self-care including forgetting or postponing glucose monitoring or medication use as well as higher consumption of high fat/high sugary foods. Diabetes may also disturb sleep, for example through nocturnal hypoglycemia and nocturia. We concluded that sleep and circadian rhythm disturbances are closely linked with diabetes. More attention to sleep in regular diabetes care is warranted, while further research is needed on treatment of sleep and circadian rhythm disturbances in the prevention of diabetes and its suboptimal outcomes.Keywords: sleep, sleep disorders, circadian rhythm, type 1 diabetes, type 2 diabetes
