AUTHOR=Fan Bingge , Tang Ting , Zheng Xiao , Ding Haixia , Guo Peng , Ma Hongqing , Chen Yu , Yang Yichao , Zhang Lihui TITLE=Sleep disturbance exacerbates atherosclerosis in type 2 diabetes mellitus JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=10 YEAR=2023 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1267539 DOI=10.3389/fcvm.2023.1267539 ISSN=2297-055X ABSTRACT=Background

Short sleep duration and poor sleep quality are important risk factors for atherosclerosis. The use of smart bracelets that measure sleep parameters, such as sleep stage, can help determine the effect of sleep quality on lower-extremity atherosclerosis in patients with type 2 diabetes.

Objective

To investigate the correlation between sleep disorders and lower-extremity atherosclerosis in patients with type 2 diabetes.

Methods

After admission, all patients were treated with lower-extremity arterial ultrasound and graded as having diabetic lower-extremity vascular lesions according to the results. A smart bracelet was used to obtain the patient sleep data. The correlation between sleep patterns and diabetic lower-extremity atherosclerosis, diabetic foot, and various metabolic indices was verified.

Results

Between August 2021 and April 2022, we screened 100 patients with type 2 diabetes, with 80 completing sleep monitoring. Univariate ordered logistic regression analysis indicated that patients with a sleep score below 76 (OR = 2.707, 95%CI: 1.127–6.488), shallow sleep duration of 5.3 h or more (OR=3.040, 95 CI: 1.005–9.202), wakefulness at night of 2.6 times or more (OR = 4.112, 95%CI: 1.513–11.174), and a deep sleep continuity score below 70 (OR = 4.141, 95%CI: 2.460–615.674) had greater risk of high-grade lower limb atherosclerosis. Multivariate ordinal logistic regression analysis revealed that the risk of high-grade lower limb atherosclerosis was higher in patients with 2.6 or more instances of nighttime wakefulness (OR = 3.975, 95%CI: 1.297–12.182) compared with those with fewer occurrences. The sleep duration curve of patients with different grades of diabetic lower-extremity atherosclerosis was U-shaped. According to the results of the one-way analysis of variance, the higher the deep sleep continuity score, the lower the Wagner scale score for diabetic foot (P < 0.05).

Conclusions

Sleep disorders (long, shallow sleep duration, frequent wakefulness at night, and poor continuity of deep sleep) can worsen lower limb atherosclerosis in patients with type 2 diabetes. This finding can provide a new method for medical professionals to prevent and treat diabetic lower-extremity vascular lesions.