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CC BY-NC-ND 4.0 · Sleep Sci 2022; 15(S 01): 184-194
DOI: 10.5935/1984-0063.20220018
ORIGINAL ARTICLES

Cardiovascular risk associated with co-morbid insomnia and sleep apnoea (COMISA) in type 2 diabetics

Authors

  • Matthieu Hein

    1   Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB - Anderlecht - Bruxelles - Belgium.

  • Jean-Pol Lanquart

    1   Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB - Anderlecht - Bruxelles - Belgium.

  • Anais Mungo

    1   Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB - Anderlecht - Bruxelles - Belgium.

  • Gwenolé Loas

    1   Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB - Anderlecht - Bruxelles - Belgium.
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Objective In the general population, co-morbid insomnia and sleep apnoea (COMISA) is associated with higher risk of cardiovascular diseases (CVD). However, despite a high prevalence of COMISA in type 2 diabetics, no study has investigated its potential implication in the negative cardiovascular outcome of this particular subpopulation. The aim of this study was therefore to examine the risk of CVD associated with COMISA in type 2 diabetics.

Methods Data from 471 type 2 diabetics recruited from the clinical database of the Erasme Hospital sleep laboratory were analysed. Only type 2 diabetics with SCORE index ≥5% were included in the group at high risk of CVD. Logistic regression analyses were conducted to examine the risk of CVD associated with COMISA in type 2 diabetics.

Results A high risk of CVD was present in 32.9% of type 2 diabetics. After adjustment for the main confounding factors associated with cardiovascular risk, multivariate logistic regression analysis revealed that unlike obstructive sleep apnoea syndrome or insomnia alone, only COMISA was associated with higher risk of CVD in type 2 diabetics.

Discussion In our study, we have demonstrated that unlike its components alone, only COMISA was associated with higher risk of CVD in type 2 diabetics, which highlights the importance of the central role played by the negative synergistic effect of COMISA on the cardiovascular outcome in this particular subpopulation. Thus, given these elements, more systematic research and adequate therapeutic management of COMISA seem to be necessary to allow better cardiovascular prevention in type 2 diabetics.

Sleep Apnea - Obstructive - Cardiovascular Diseases - Sleep Initiation and Maintenance Disorders - Diabetes Mellitus - Type 2 - Polysomnography

Ethics approval and consent to participate

This research protocol was approved by the Hospital and Medical School Ethics Committee of the Erasme Hospital (Brussels University Clinics) (Erasme Reference: P2021/080). At Erasme Hospital, all patients are informed that their data could be used retrospectively for scientific research. If patients do not wish for their data to be used, they must inform the hospital, at which time, this directive is indicated in their medical records, and any future use of their data is prohibited.


Consent for publication

Not applicable.


Availability of data and material

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.


Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-proft sectors.


Authors’ contributions

MH: Principal investigator of the study with active participation in the encoding of data, statistical analysis, interpretation of results and writing of the article. JL: Active participation in the extraction and calculation of data from polysomnography for the realisation of the database. AM: Support in drafting the manuscript and supervision of research work. GL: Support in drafting the manuscript and supervision of research work. All authors read and approved the fnal manuscript.


SUPPLEMENTARY DATA



Publication History

Received: 24 June 2021

Accepted: 24 September 2021

Article published online:
01 December 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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