Effects of sleep deprivation on hypoglycemia-induced cognitive impairment and recovery in adults with type 1 diabetes

Berit E Inkster; Nicola N Zammitt; Stuart J Ritchie; Ian J Deary; Ian Morrison; Brian M Frier

doi:10.2337/dc15-2335

Effects of sleep deprivation on hypoglycemia-induced cognitive impairment and recovery in adults with type 1 diabetes

Berit E Inkster, Nicola N Zammitt, Stuart J Ritchie, Ian J Deary, Ian Morrison, Brian M Frier

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To ascertain whether hypoglycemia in association with sleep deprivation causes greater cognitive dysfunction than hypoglycemia alone and protracts cognitive recovery after normoglycemia is restored.

RESEARCH DESIGN AND METHODS: Fourteen adults with type 1 diabetes underwent a hyperinsulinemic, hypoglycemic clamp on two separate occasions. Before one glucose clamp, the participants stayed awake overnight to induce sleep deprivation. Participants were randomized and counterbalanced to the experimental condition. Cognitive function tests were performed before and during hypoglycemia and for 90 min after restoration of normoglycemia.

RESULTS: Cognitive impairment during hypoglycemia did not differ significantly between the sleep-deprived and non-sleep-deprived conditions. However, in the sleep-deprived state, digit symbol substitution scores and choice reaction times were significantly poorer during recovery (P < 0.001) and hypoglycemia symptom scores were significantly higher (P < 0.001), even when symptoms that may have been caused by sleep deprivation, such as tiredness, were removed.

CONCLUSIONS: Hypoglycemia per se produced a significant decrement in cognitive function; coexisting sleep deprivation did not have an additive effect. However, after restoration of normoglycemia, preceding sleep deprivation was associated with persistence of hypoglycemic symptoms and greater and more prolonged cognitive dysfunction during the recovery period.

Original language	English
Journal	Diabetes Care
Volume	39
Issue number	5
DOIs	https://doi.org/10.2337/dc15-2335
Publication status	Published - 22 Mar 2016

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Inkster-etal-DC-2016-effects-of-sleep-deprivation.pdf
This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Care Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version is available in print and online at 10.2337/dc15-2335.
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Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2.
Maclullich, A. (Principal Investigator)
1/09/13 → 31/08/19
Project: Research
RA2661 Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2. Main Budget.
Deary, I. (Principal Investigator), Gale, C. (Co-investigator), Holmes, M. (Co-investigator), Logie, P. (Co-investigator), Maclullich, A. (Co-investigator), Porteous, D. (Co-investigator), Seckl, J. (Co-investigator), Starr, J. (Co-investigator), Wardlaw, J. (Co-investigator) & Okely, J. (Researcher)
1/09/13 → 31/08/19
Project: Research
MRC Centre for Cognitive Ageing and Cognitive Epidemiology
Deary, I. (Principal Investigator), Holmes, M. (Co-investigator), Logie, P. (Co-investigator), McCulloch, J. (Co-investigator), Porteous, D. (Co-investigator), Roberts, N. (Co-investigator), Seckl, J. (Co-investigator), Starr, J. (Co-investigator) & Wardlaw, J. (Co-investigator)
MRC
1/09/08 → 31/08/13
Project: Research

Cite this

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title = "Effects of sleep deprivation on hypoglycemia-induced cognitive impairment and recovery in adults with type 1 diabetes",

abstract = "OBJECTIVE: To ascertain whether hypoglycemia in association with sleep deprivation causes greater cognitive dysfunction than hypoglycemia alone and protracts cognitive recovery after normoglycemia is restored.RESEARCH DESIGN AND METHODS: Fourteen adults with type 1 diabetes underwent a hyperinsulinemic, hypoglycemic clamp on two separate occasions. Before one glucose clamp, the participants stayed awake overnight to induce sleep deprivation. Participants were randomized and counterbalanced to the experimental condition. Cognitive function tests were performed before and during hypoglycemia and for 90 min after restoration of normoglycemia.RESULTS: Cognitive impairment during hypoglycemia did not differ significantly between the sleep-deprived and non-sleep-deprived conditions. However, in the sleep-deprived state, digit symbol substitution scores and choice reaction times were significantly poorer during recovery (P < 0.001) and hypoglycemia symptom scores were significantly higher (P < 0.001), even when symptoms that may have been caused by sleep deprivation, such as tiredness, were removed.CONCLUSIONS: Hypoglycemia per se produced a significant decrement in cognitive function; coexisting sleep deprivation did not have an additive effect. However, after restoration of normoglycemia, preceding sleep deprivation was associated with persistence of hypoglycemic symptoms and greater and more prolonged cognitive dysfunction during the recovery period.",

author = "Inkster, {Berit E} and Zammitt, {Nicola N} and Ritchie, {Stuart J} and Deary, {Ian J} and Ian Morrison and Frier, {Brian M}",

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AU - Inkster, Berit E

AU - Zammitt, Nicola N

AU - Ritchie, Stuart J

AU - Deary, Ian J

AU - Morrison, Ian

AU - Frier, Brian M

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N2 - OBJECTIVE: To ascertain whether hypoglycemia in association with sleep deprivation causes greater cognitive dysfunction than hypoglycemia alone and protracts cognitive recovery after normoglycemia is restored.RESEARCH DESIGN AND METHODS: Fourteen adults with type 1 diabetes underwent a hyperinsulinemic, hypoglycemic clamp on two separate occasions. Before one glucose clamp, the participants stayed awake overnight to induce sleep deprivation. Participants were randomized and counterbalanced to the experimental condition. Cognitive function tests were performed before and during hypoglycemia and for 90 min after restoration of normoglycemia.RESULTS: Cognitive impairment during hypoglycemia did not differ significantly between the sleep-deprived and non-sleep-deprived conditions. However, in the sleep-deprived state, digit symbol substitution scores and choice reaction times were significantly poorer during recovery (P < 0.001) and hypoglycemia symptom scores were significantly higher (P < 0.001), even when symptoms that may have been caused by sleep deprivation, such as tiredness, were removed.CONCLUSIONS: Hypoglycemia per se produced a significant decrement in cognitive function; coexisting sleep deprivation did not have an additive effect. However, after restoration of normoglycemia, preceding sleep deprivation was associated with persistence of hypoglycemic symptoms and greater and more prolonged cognitive dysfunction during the recovery period.

AB - OBJECTIVE: To ascertain whether hypoglycemia in association with sleep deprivation causes greater cognitive dysfunction than hypoglycemia alone and protracts cognitive recovery after normoglycemia is restored.RESEARCH DESIGN AND METHODS: Fourteen adults with type 1 diabetes underwent a hyperinsulinemic, hypoglycemic clamp on two separate occasions. Before one glucose clamp, the participants stayed awake overnight to induce sleep deprivation. Participants were randomized and counterbalanced to the experimental condition. Cognitive function tests were performed before and during hypoglycemia and for 90 min after restoration of normoglycemia.RESULTS: Cognitive impairment during hypoglycemia did not differ significantly between the sleep-deprived and non-sleep-deprived conditions. However, in the sleep-deprived state, digit symbol substitution scores and choice reaction times were significantly poorer during recovery (P < 0.001) and hypoglycemia symptom scores were significantly higher (P < 0.001), even when symptoms that may have been caused by sleep deprivation, such as tiredness, were removed.CONCLUSIONS: Hypoglycemia per se produced a significant decrement in cognitive function; coexisting sleep deprivation did not have an additive effect. However, after restoration of normoglycemia, preceding sleep deprivation was associated with persistence of hypoglycemic symptoms and greater and more prolonged cognitive dysfunction during the recovery period.

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JO - Diabetes Care

JF - Diabetes Care

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Effects of sleep deprivation on hypoglycemia-induced cognitive impairment and recovery in adults with type 1 diabetes

Abstract

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Projects

Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2.

RA2661 Centre for Cognitive Ageing and Cognitive Epidemiology Phase 2. Main Budget.

MRC Centre for Cognitive Ageing and Cognitive Epidemiology

Cite this