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Associations between type 2 diabetes and sleep problems in midlife women

Hormone changes are known to alter insulin sensitivity and glucose metabolism, as well as interfere with women's sleep patterns. But little was known about the association between diabetes and sleep disturbances during the menopause transition until now, as a new study concludes that women with diabetes are at greater risk for sleep disturbances. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Estrogen and progesterone are known to influence cell response to insulin. As a result, it has been suspected that the hormone changes of the menopause transition could cause fluctuations in a woman's blood sugar levels, putting her at greater risk of diabetes. Statistically, midlife women have a higher prevalence rate of type 2 diabetes during the menopause transition.

Similarly, hormone changes have been shown to affect a woman's quality of sleep. Mainly because of night sweats and hot flashes caused by hormone changes, about 42% of premenopausal and 60% of postmenopausal women reportedly have sleep disturbances. For those with diabetes, sleep difficulties could be worsened by various diabetes symptoms and related medications that cause, among other problems, more frequent urination that could wake women up multiple times during the night. At the same time, sleep is identified as a key factor in trying to prevent and manage diabetes.

Despite all these acknowledged associations, few studies to date have evaluated the possible association between diabetes and sleep disturbances during the menopause transition. However, a new study based on data from two larger Internet survey studies showed that the mean total number of sleep-related symptoms was significantly higher in those with type 2 diabetes than those without the disease. The severity of the sleep problems was also greater for women with diabetes. Although this association was demonstrated in four major racial/ethnic groups in the United States it was particularly pronounced in Asian women.

Abstract

OBJECTIVES:
The purpose of this study was to determine the associations between type 2 diabetes mellitus and sleep-related symptoms among midlife women from four major racial/ethnic groups in the United States.

METHODS:
The data from 164 participants of two larger Internet survey studies (62 women diagnosed with type 2 diabetes and 102 women without diabetes) were included. In the original studies, multiple instruments including the questions on background characteristics, health status, and menopause status and the Sleep Index for Midlife Women were used. The data were analyzed using χ tests, independent t tests, Mann-Whitney U tests, and hierarchical multiple regression analyses.

RESULTS:
The mean total number of sleep-related symptoms was significantly higher in those with type 2 diabetes (9.95 ± 5.83) than those without diabetes (7.25 ± 6.08) (t = 2.81, P = 0.006). The mean total severity score of sleep-related symptoms was also significantly higher in those with type 2 diabetes (33.42 ± 22.41) than those without diabetes (21.87 ± 21.40) (t = 3.29, P = 0.001). Among postmenopausal women and Asian women, there were significant differences in total numbers and total severity scores between those with type 2 diabetes and those without diabetes (all P < 0.05). When background characteristics, health status, and menopause status were controlled, having a diagnosis of type 2 diabetes was positively associated with total numbers (β=0.143, P = 0.047) and total severity scores (β=0.176, P = 0.014) of sleep-related symptoms.

CONCLUSIONS:
This secondary analysis supported significant associations of type 2 diabetes to sleep-related symptoms of midlife women from four major racial/ethnic groups in the United States.

Reference

Im EO, Yang YL, Liu J, Chee W. Sleep-related symptoms of midlife women with and without type 2 diabetes mellitus. Menopause. 2019 Aug 12. doi: 10.1097/GME.0000000000001383. [Epub ahead of print]

Content created 16 August 2019

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