Sleep Apnea in Type 1 Diabetes
Condition: Type 1 Diabetes, Sleep Apnea Syndrome
MeSH terms: Apnea; Sleep Apnea Syndromes; Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      Sleep apnea syndrome is strongly associated to type 2 diabet, partly and this is partly due
      to obesity. Treatment of sleep apnea may improve hypertension, cardiovascular risk and in
      some studies diabetes status. Few data are available for type 1 diabetes but suggest that the
      prevalence of sleep apnea syndrome may be high. We plan to compare the prevalence of sleep
      apnea syndrome assessed by polysomnography in a sample of type 1 diabetic patients and a
      control group matched by age, gender and body mass index. The secondary objective is to
      determine if the presence of an autonomic neuropathy or poorly controlled diabetes (assessed
      by glycosylated haemoglobin) may or not contribute to the presence of sleep apnea in the
      diabetic group.
    

Detailed description: 
      Diagnostic protocol designed to evaluate if if sleep apnea syndrome is more frequent in type
      1 diabetes than in general population and therefore deserves to be more systematically
      suspected and actively diagnosed in this patients. Sleep apnea syndrome is a heavy burden as
      a matter of quality of life: it is responsible for fatigue, diurnal sleepiness, cognitive
      impairment, poor and /or non restorative sleep, morning headaches, depressive mood…Adequate
      treatment provides a rapid and, most of the time, complete relief of these symptoms.

      On an other hand, Sleep Apnea is and independent risk factor for cardiovascular mortality and
      morbidity in young and middle aged subjects, also reversed by treatment. It might be
      therefore important for type 1 diabetic patients who have already an increased cardiovascular
      risk to be properly diagnosed for sleep apnea. A systematic screening for sleep apnea is
      already recommended for patients with type 2 diabetes by experts.

      A secondary objective is to determine if the presence of a sleep apnea syndrome in type 1
      diabetic patients is associated to an autonomic neuropathy, a poor glycemic control , a
      poorer quality of life , a poorer quality of sleep, more severe cardiovascular consequences
      and biological impairment.
    

Intervention name(s): Polysomnography; Evaluation of the autonomous nervous system; Clinical examination of the sleep; Clinical examination of diabetology; Biological dosages; Electrocardiogram (ECG); Carotid echography; Blood pressure
Intervention type(s): Other; Other; Other; Other; Other; Other; Other; Other
Intervention description(s): Diabetes people: Examination diagnosis of the sleep apnea A night at the hospital; blood pressure, Heart frequence, deep breath, Orthostatism, Vasalva, Low blood pressure orthostatic; Functional signs, collection of medical histories and associated pathologies, Pittsburgh Sleep Quality Index PSQI, Functional Outcomes of Sleep Questionnaire FOSQ, Epworth Sleepiness Scale ESS, Hospital Anxiety and Depression scale HAD; history of diabet, observance, ophthalmological, renal, macroangiopathic and neuronal complications, Toronto scale, Diabetes Quality of Life (DQOL) Questionnaire; Hematology, glycemia, lipids, CRP, creatinine, ferritin, glycosylated hemoglobin, transaminase, microalbuminuria, urine test; Electrocardiogram (ECG); Carotid echography; Blood pressure
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: Type 1 diabetes, sleep apnea, polysomnography,; autonomic neuropathy, intima media thickness