Interactions between hypoglycemia and sleep architecture in children with type 1 diabetes mellitus
Autor: | Atul Malhotra, Karen C. McCowen, Ram Weiss, Nir Peled, Arie Shlitner, Naim Shehadeh, Giora Pillar, Guy Schuscheim |
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Rok vydání: | 2003 |
Předmět: |
Blood Glucose
Male medicine.medical_specialty Sympathetic Nervous System Adolescent Polysomnography Rapid eye movement sleep Hypoglycemia Severity of Illness Index Arousal Heart Rate Risk Factors Internal medicine Diabetes mellitus medicine Humans Circadian rhythm Wakefulness Child Slow-wave sleep Type 1 diabetes business.industry medicine.disease Sleep in non-human animals Diabetes Mellitus Type 1 Endocrinology Case-Control Studies Pediatrics Perinatology and Child Health Female Sleep Stages business |
Zdroj: | The Journal of Pediatrics. 142:163-168 |
ISSN: | 0022-3476 |
Popis: | Objectives To assess the interactions between nocturnal hypoglycemia and sleep in children with type 1 diabetes mellitus (DM). Study design Children with DM (n = 15) and 15 matched control children underwent full night polysomnographic recordings. Blood glucose levels were measured in the diabetic children by means of the MiniMed Continuous Glucose Monitoring System. Six of the diabetic children were also studied by peripheral arterial tonometry (an indirect indicator of sympathetic responses). Results Five children with DM (33%) had profound nocturnal hypoglycemia, which was associated with increased sleep efficiency, increased slow wave sleep, and increased Δ power in spectral analysis of the electroencephalogram. Hypoglycemic episodes were not associated with sympathetic activation. Rapid decline in glucose levels (>25 mg/dL/hour) but not the absolute degree of hypoglycemia were associated with awakenings from sleep. Conclusions We conclude that sleep may inhibit sympathetic and arousal response to hypoglycemia. Rapid changes in glucose levels, independent of absolute glucose levels, may result in awakening from sleep. Continuous measurement of glucose levels during sleep may add important features in the treatment of children with DM. (J Pediatr 2003;142:163-8) |
Databáze: | OpenAIRE |
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