Daytime sleepiness in patients with type 2 Diabetes Mellitus : a prospective cohort study

Abstract

Introduction: Daytime sleepiness is an independent factor for increased health care utilization and all cause mortality. Diabetic patients are more likely to be sleepy during the daytime than non-diabetics.

Objectives to examine factors influencing the evolution of daytime sleepiness in patients with type 2 diabetes (T2D) in a two-year follow-up study.

Methods: Patients (N=145) aged from 40 to 60 (55.0±3.3) of both genders were consecutively recruited and evaluated for comorbidity severity (Charlson Comorbidity Index), depressive symptoms (Beck Depression Inventory, BDI II), sleep quality (Pittsburgh Sleep Quality Index) and physical activity levels (International Physical Activity Questionnaire, IPAQ). Daytime sleepiness was assessed by the Epworth Sleepiness Scale (ESS)

Results: Excessive daytime sleepiness (ESS>10) was found in 51 (35.2%) patients. Initially, men had more excessive daytime sleepiness; however, women evolved with more sleepiness after two years. Levels of physical activity were independently associated with more excessive daytime sleepiness and patients with a sedentary lifestyle developed worse levels of daytime sleepiness after two years. Active lifestyle was more beneficial for reducing daytime sleepiness in women. In this study, among all, levels of physical activity (IPAQ) improved after two years. Conclusion: Excessive daytime sleepiness affects approximately 1/3 of T2D patients and women evolve with more sleepiness. Better levels of physical activity are independently associated with less daytime sleepiness reinforcing the concept that a sedentary lifestyle has a negative influence in sleep-wake alterations. The implementation of physical exercise is a possible break of chain involving sleep-wake alterations and comorbidities in T2D.