Samiul A Mostafa, Wasim Hanif, Francesca Crowe, George Balanos, Krishnarajah Nirantharakumar, Jason G Ellis, Abd A Tahrani
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The pooled mean differences were calculated by the inverse variance method.</p><p><strong>Results: </strong>24 studies (15 CBT-I and/or sleep hygiene; 9 sleep extension) were included. Meta-analysis of 12 studies (<i>n</i> = 2,044) of CBT-I and/or sleep hygiene demonstrated a significant reduction in HbA1c of 0.27% (95% CI 0.07, 0.47, I<sup>2</sup> 74%, <i>p</i> = 0.008) compared to control. In T2DM (<i>n</i> = 1,911; 9 studies), HbA1c level decrease was 0.43% (0.19, 0.67, I<sup>2</sup> 59%, <i>p</i> = 0.0004). There were no significant changes in fasting blood glucose analyses nor in any sleep extension intervention. For quality assessment, only 9 studies had low concern.</p><p><strong>Conclusions: </strong>Using CBT-I and/or sleep hygiene interventions led to significant reductions in HbA1c levels, which were clinically meaningful in T2DM. 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引用次数: 0
摘要
背景：众所周知，睡眠不足会对葡萄糖代谢产生负面影响。因此，人们对确定改善睡眠对葡萄糖代谢的影响很感兴趣。我们进行了一项荟萃分析，旨在利用失眠认知行为疗法（CBT-I）和/或睡眠卫生或睡眠延长对葡萄糖代谢的影响来改善睡眠。方法：在MEDLINE、EMBASE、CINAHL和Cochrane上进行检索。我们纳入了成人≥18岁、睡眠干预和血糖测量的研究。用反方差法计算合并平均差值。结果：24项研究(15项CBT-I和/或睡眠卫生；包括9例睡眠延长)。12项关于CBT-I和/或睡眠卫生的研究（n = 2,044）的荟萃分析显示，与对照组相比，HbA1c显著降低0.27% （95% CI 0.07, 0.47, I2 74%, p = 0.008）。T2DM患者(n = 1,911；9项研究)，HbA1c水平降低0.43% （0.19,0.67,I2 59%, p = 0.0004）。空腹血糖分析和任何睡眠延长干预都没有显著变化。在质量评价方面，只有9项研究低关注。结论：使用CBT-I和/或睡眠卫生干预可显著降低HbA1c水平，这对T2DM患者具有临床意义。解决睡眠不足应该是糖尿病护理的一个组成部分。注册：普洛斯彼罗识别号：CRD42022376606。
The effect of non-pharmacological sleep interventions on glycaemic measures in adults with sleep disturbances and behaviours: A systematic review and meta-analysis.
Background: Sleep insufficiency is known to negatively impact on glucose metabolism. Consequently, there is interest in determining the impact of improving sleep on glucose metabolism. We conducted a meta-analysis of studies that aimed at improving sleep using cognitive behavioural therapy for insomnia (CBT-I) and/or sleep hygiene or sleep extension on glucose metabolism.
Methods: Searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults≥18years, a sleep intervention and glycaemic measurements. The pooled mean differences were calculated by the inverse variance method.
Results: 24 studies (15 CBT-I and/or sleep hygiene; 9 sleep extension) were included. Meta-analysis of 12 studies (n = 2,044) of CBT-I and/or sleep hygiene demonstrated a significant reduction in HbA1c of 0.27% (95% CI 0.07, 0.47, I2 74%, p = 0.008) compared to control. In T2DM (n = 1,911; 9 studies), HbA1c level decrease was 0.43% (0.19, 0.67, I2 59%, p = 0.0004). There were no significant changes in fasting blood glucose analyses nor in any sleep extension intervention. For quality assessment, only 9 studies had low concern.
Conclusions: Using CBT-I and/or sleep hygiene interventions led to significant reductions in HbA1c levels, which were clinically meaningful in T2DM. Addressing sleep insufficiency should be an integral part of diabetes care.
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