Sleep and glycemic control in type 1 diabetes.

OBJECTIVE: Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment. MATERIALS AND METHODS: Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evaluated through: A1C, home fingertip glucometer for 10 days (concomitant with the sleep diary and actimeter), and CGM or concomitant with continuous glucose monitoring (during the polysomnography night). RESULTS: Comparing with the control group, individuals with diabetes presented more pronounced sleep extension from weekdays to weekends than control subjects (p = 0.0303). Among T1DM, glycemic variability (SD) was positively correlated with sleep latency (r = 0.6525, p = 0.0033); full awakening index and arousal index were positively correlated with A1C (r = 0.6544, p = 0.0081; and r = 0.5680, p = 0.0272, respectively); and mean glycemia values were negatively correlated with sleep quality in T1DM individuals with better glycemic control (mean glycemia < 154 mg/dL). CONCLUSION: Our results support the hypothesis of an interaction between sleep parameters and T1DM, where the glycemic control plays an important role. More studies are needed to unveil the mechanisms behind this interaction, which may allow, in the future, clinicians and educators to consider sleep in the effort of regulating glycemic control.

Sleep and glycemic control in type 1 diabetes

Objective Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment. Materials and methods Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evaluated through: A1C, home fingertip glucometer for 10 days (concomitant with the sleep diary and actimeter), and CGM or concomitant with continuous glucose monitoring (during the polysomnography night). Results Comparing with the control group, individuals with diabetes presented more pronounced sleep extension from weekdays to weekends than control subjects (p = 0.0303). Among T1DM, glycemic variability (SD) was positively correlated with sleep latency (r = 0.6525, p = 0.0033); full awakening index and arousal index were positively correlated with A1C (r = 0.6544, p = 0.0081; and r = 0.5680, p = 0.0272, respectively); and mean glycemia values were negatively correlated with sleep quality in T1DM individuals with better glycemic control (mean glycemia < 154 mg/dL). Conclusion Our results support the hypothesis of an interaction between sleep parameters and T1DM, where the glycemic control plays an important role. More studies are needed to unveil the mechanisms behind this interaction, which may allow, in the future, clinicians and educators to consider sleep in the effort of regulating glycemic control. Arch Endocrinol Metab. 2015;59(1):71-8 .

Sleep patterns and sleepiness among young students: A longitudinal study before and after admission as trainees and apprentices.

In developing countries, youngsters start to work during the high school years. Several studies have shown the difficulties associated with double shift, i.e. to work and study concomitantly, and its negative health consequences. Work and study time, as social synchronizers, have significant effects on the sleep-wake cycle (SWC). The purpose of this study was to evaluate sleep patterns and sleepiness in young students before and after entering the workforce as apprentices or trainees. Participants were 40 adolescents (26 males), 15-18 years old (mean = 15.8 years old) engaged in a first-job program at a non-governmental organization (NGO) while attending evening high school in the outskirts of the city of São Paulo, Brazil. The participants wore actigraphs (Ambulatory Monitoring, Inc.) and registered subjective sleepiness on KSS (Karolinska Sleepiness Scale) along 7 consecutive days, before and after admission to the job. Descriptive analyses were performed, and the variables were tested by means of the t-test and repeated measures ANOVA taking factors day of the week and time of the day into consideration. The participants' sleep duration on weekdays exhibited significant difference before and after starting work (F = 4.55; p = 0.04); the mean sleep duration was 492 min (SD = 44 min) before admission to the job to decrease to 405 min (SD = 58 min) after starting work. The mid-sleep time exhibited significant difference on weekdays before and after starting work (04:57 h; SD = 45 min versus 03:30 h; SD = 54 min; F = 4.91; p = 0.03). Finally, also sleepiness on weekdays (F = 6.41; p = 0.04) and at the waking time (F = 10.75; p < 0.01) exhibited significant difference before and after admission to the job. This article emphasizes the fact that social synchronizers like working during the day and studying in the evening changed the participants' SWC and were associated with sleep restriction. Brazilian governmental incentives notwithstanding, simultaneous performance of several activities by young workers should be considered as an occupational health hazard. Employment policies targeting young workers should take the dual shift - study and work - and its effects on the sleep-wake cycle into account.

Daily rhythms of native Brazilians in summer and winter.

Access to electricity, granting relative independence of human activity on the dark phase of the day, has been pointed out as an important cause for the absence of seasonal changes in the daily rhythms of humans living in urban areas. Featuring a population of adult Guarani natives living without access to electricity, the present naturalistic study was designed to explore possible effects of different natural photoperiods and temperature on human circadian rhythms. We compared time series of wrist temperature (WT) and motor activity in winter and summer, respectively, of 24 individuals aged 18 to 80. Twenty-four-hour rhythms of WT showed lower amplitudes and higher mean levels in summer, with no significant seasonal differences in acrophase. In contrast, rest-activity (RA) rhythms exhibited a significantly later rest on- and offset in summer, but no seasonal changes in duration, amplitude and mean level. We furthermore identified a phase advance of both the WT acrophase and rest onset with increasing age of the individuals. We concluded that in our study the effect of different seasons was reflected in the amplitude and mean level of the WT rhythm, as well the onset of nighttime rest, which was delayed in summer.

Ontogênese do sistema de temporização: a construção e as reformas dos ritmos biológicos ao longo da vida humana / L'ontogenèse du système de temporisation: sa constrution et les changements de rythmes biologiques au long de la vie humaine / Ontogeny of the timing system: building and reforms of biological rhythms along human life

Nesta revisão apresentamos fatos e comentários sobre a evolução dos sistemas de temporização ("relógios biológicos") na espécie humana. Na Introdução definimos alguns conceitos básicos da Cronobiologia que serão utilizados ao longo do artigo. Nas quatro seções subseqüentes, discutimos fatos marcantes que caracterizam a ritmicidade biológica em distintas etapas da ontogênese: bebês, adolescentes, adultos e idosos. Concluímos o artigo com um convite à reflexão sobre as perspectivas que se abrem com esse novo campo do conhecimento.

In this review we present facts and comments on the evolution of the timing systems ("biological clocks") in humans. In the Introduction we define basic concepts of Chronobiology which will be used along the paper. In the four following sections we discuss landmarks which characterize biological rhythmicity in distinct moments of ontogeny: infants, adolescents, adults and elderly. We close the review with an invitation to consider the perspectives now open in this new area of knowledge.

Cette révision présente certains faits et des commentaires sur l' ontogenèse des systèmes de temporisation (®les horloges biologiques¼) chez l'homme. D´abord, nous présentons quelques défi nitions fondamentales de la Chronobiologie, ce qui nous semble nécessaire à la compréhension du texte suivant. Les quatre sections organisées à la suite abordent des faits remarquables qui caractérisent la rhythmicité biologique au cours de l'ontogenèse chez les bébés, les adolescents, les adultes et les anciens. A la conlusion nous proposons une réflexion sur les perspectives qui s´ouvrent par ce nouveau champ de connaissance.

Ontogênese do sistema de temporização: a construção e as reformas dos ritmos biológicos ao longo da vida humana / L'ontogenèse du système de temporisation: sa constrution et les changements de rythmes biologiques au long de la vie humaine / Ontogeny of the timing system: building and reforms of biological rhythms along human life

Nesta revisão apresentamos fatos e comentários sobre a evolução dos sistemas de temporização ('relógios biológicos') na espécie humana. Na Introdução definimos alguns conceitos básicos da Cronobiologia que serão utilizados ao longo do artigo. Nas quatro seções subseqüentes, discutimos fatos marcantes que caracterizam a ritmicidade biológica em distintas etapas da ontogênese: bebês, adolescentes, adultos e idosos. Concluímos o artigo com um convite à reflexão sobre as perspectivas que se abrem com esse novo campo do conhecimento.(AU)

In this review we present facts and comments on the evolution of the timing systems ('biological clocks') in humans. In the Introduction we define basic concepts of Chronobiology which will be used along the paper. In the four following sections we discuss landmarks which characterize biological rhythmicity in distinct moments of ontogeny: infants, adolescents, adults and elderly. We close the review with an invitation to consider the perspectives now open in this new area of knowledge.(AU)

Cette révision présente certains faits et des commentaires sur l' ontogenèse des systèmes de temporisation (®les horloges biologiques») chez l'homme. D´abord, nous présentons quelques défi nitions fondamentales de la Chronobiologie, ce qui nous semble nécessaire à la compréhension du texte suivant. Les quatre sections organisées à la suite abordent des faits remarquables qui caractérisent la rhythmicité biologique au cours de l'ontogenèse chez les bébés, les adolescents, les adultes et les anciens. A la conlusion nous proposons une réflexion sur les perspectives qui s´ouvrent par ce nouveau champ de connaissance.(AU)