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Master Thesis

Impact des caractéristiques du sommeil sur l'équilibre glycémique du diabète de type 1 : rôle du Social Jetlag

Abstract : Sleep behavior is changing toward shorter sleep duration and later chronotype. It results in a sleep debt that is acquitted on work-free days, inducing a small but recurrent sleep misalignment each week, referred to as “social jetlag”. These sleep habits could affect health through misalignment with circadian rhythms. Study Objectives: To address the impact of sleep behavior on glycemic control in patients with type 1 diabetes, independently of other lifestyle or sleep-related factors. Secondary objective: to address whether circadian phase impacts glycemic control. Methods: Eighty adult patients with type 1 diabetes (46% female) were included in a cross-sectional, observational study. Sleep behavior was addressed objectively by a 7-days actimetry, lifestyle by questionnaires, sleep breathing disorders by nocturnal oximetry and circadian phase by dim light melatonin onset (DLMO). Main outcome: HbA1c. Results: Univariate analyses showed that chronotype (r=0.23, p=0.042) and social jetlag (r=0.30, p=0.008) were significantly associated with HbA1c. In multivariable analysis, social jetlag was the only sleep habit independently associated with HbA1c (β=0.012 (0.006; 0.017), p<0.001). HbA1c was lower in patients with a social jetlag below vs. above the median (7.7% [7.1-8.7] and 8.7% [7.6-9.8], p=0.011). DLMO was not associated with HbA1c. However, the later the DLMO the worse the sleep efficiency (r=-0.41, p<0.001) and fragmentation index (r=0.35, p=0.005). Conclusions: Social jetlag, a small but recurrent circadian misalignment, is associated with worse glycemic control in type 1 diabetes whereas circadian phase is not. Further intervention studies should address the potential improvement of glycemic control by correcting social jetlag.
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Master Thesis
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Submitted on : Monday, June 13, 2016 - 3:44:43 PM
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  • HAL Id : dumas-01331192, version 1


Sandra Larcher. Impact des caractéristiques du sommeil sur l'équilibre glycémique du diabète de type 1 : rôle du Social Jetlag . Médecine humaine et pathologie. 2016. ⟨dumas-01331192⟩



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