{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T08:31:48Z","timestamp":1793003508896,"version":"4.5.0"},"reference-count":47,"publisher":"American Diabetes Association","issue":"3","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,3,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To test the hypothesis that diabetes is independently associated with sleep-disordered breathing (SDB), and in particular that diabetes is associated with sleep abnormalities of a central, rather than obstructive, nature.<\/jats:p>\n                  <jats:p>RESEARCH DESIGN AND METHODS\u2014Using baseline data from the Sleep Heart Health Study (SHHS), we related diabetes to 1) the respiratory disturbance index (RDI; number of apneas plus hypopneas per h of sleep); 2) obstructive apnea index (OAI; \u22653 apneas\/h of sleep associated with obstruction of the upper airway); 3) percent of sleep time &amp;lt; 90% O2 saturation; 4) central apnea index (CAI; \u22653 apneas [without respiratory effort]\/h sleep); 5) occurrence of a periodic breathing (Cheyne Stokes) pattern; and 6) sleep stages. Initial analyses excluding persons with prevalent cardiovascular disease (CVD) were repeated including these participants.<\/jats:p>\n                  <jats:p>RESULTS\u2014Of the 5,874 participants included in this report, 692 (11.8%) reported diabetes or were taking oral hypoglycemic medications or insulin and 1,002 had prevalent CVD. Among the 4,872 persons without CVD, 470 (9.6%) had diabetes. Diabetic participants had worse CVD risk factor profiles than their nondiabetic counterparts, including higher BMI, waist and neck circumferences, triglycerides, higher prevalence of hypertension, and lower HDL cholesterol (P &amp;lt; 0.001, all). Descriptive analyses indicated differences between diabetic and nondiabetic participants in RDI, sleep stages, sleep time &amp;lt;90% O2 saturation, CAI, and periodic breathing (P &amp;lt; 0.05, all). However, multivariable regression analyses that adjusted for age, sex, BMI, race, and neck circumference eliminated these differences for all sleep measures except percent time in rapid eye movement (REM) sleep (19.0% among diabetic vs. 20.1% among nondiabetic subjects, P &amp;lt; 0.001) and prevalence of periodic breathing (odds ratio [OR] for diabetic subjects versus nondiabetic subjects 1.80, 95% CI 1.02\u20133.15). Additionally, adjusted analyses showed diabetes was associated with nonstatistically significant elevations in the odds of an increased central breathing index (OR 1.42, 95% CI 0.80\u20132.55). Addition to the analysis of the 1,002 persons with prevalent CVD (including 222 people with diabetes) did not materially change these results.<\/jats:p>\n                  <jats:p>CONCLUSIONS\u2014These data suggest that diabetes is associated with periodic breathing, a respiratory abnormality associated with abnormalities in the central control of ventilation. Some sleep disturbances may result from diabetes through the deleterious effects of diabetes on central control of respiration. The high prevalence of SDB in diabetes, although largely explained by obesity and other confounders, suggests the presence of a potentially treatable risk factor for CVD in the diabetic population.<\/jats:p>","DOI":"10.2337\/diacare.26.3.702","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T17:51:27Z","timestamp":1173117087000},"page":"702-709","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":413,"title":["Diabetes and Sleep Disturbances"],"prefix":"10.2337","volume":"26","author":[{"given":"Helaine E.","family":"Resnick","sequence":"first","affiliation":[{"name":"MedStar Research Institute, Hyattsville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Shahar","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Gilpin","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Newman","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Walter","sequence":"additional","affiliation":[{"name":"Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon A.","family":"Ewy","sequence":"additional","affiliation":[{"name":"University of Arizona, Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara V.","family":"Howard","sequence":"additional","affiliation":[{"name":"MedStar Research Institute, Hyattsville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh M.","family":"Punjabi","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031220332345600_R1","unstructured":"Grunstein RR, Stenlof K, Hedner J, Sjostrom L: Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish Obese Subjects (SOS) Study. 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