Study On The Change Of Autonomic Nerve Function In Insomnia Disorder Patients With Diabetes

Objective:In this study,sleep diary,SCOPA-AUT,Heart rate variability(HRV)and other methods were used to comprehensively evaluate the changes of autonomic nervous function in patients with insomnia disorder and diabetes mellitus.Research Methods:A total of 120 patients who met the inclusion criteria were selected from the sleep clinic and endocrinology Clinic of the Department of Neurology,the First Hospital of Jilin University from June 2021 to September 2022,including: insomnia disorder combined with diabetes group,insomnia disorder group,simple diabetes group and normal control group,with 30 patients in each group.All enrolled patients underwent heart rate variability(HRV)test,sleep diary,Insomnia Disorder Severity Index(ISI)scale,Pittsburgh Sleep Quality Index(PSQI),Depression Screening form(PHQ-9),general Hospital anxiety/Depression/mood measurement(HAD),height,weight,body mass index,fasting blood glucose.The course of insomnia disorder in patients with insomnia disorder.Diabetic course,postprandial blood glucose measurement,glycosylated hemoglobin,fasting and postprandial islet function in diabetic patients.To investigate the changes of autonomic nervous function in each group.Outcome:1.Analysis results of sleep diary showed that the latency period of sleep in the insomnia disorder combined with diabetes group and the insomnia disorder group was longer than that in the control group.Compared with the control group,the group with insomnia disorder combined with diabetes and the group with insomnia disorder alone had longer waking time and increased waking times at night.The sleep efficiency of insomnia disorder combined with diabetes and insomnia alone group was lower than that of control group(p<0.05).2.Scale evaluation results showed that the scores of ISI and PSQI in the insomnia disorder combined with diabetes group were higher than those in the insomnia disorder group alone(p<0.001).3.Autonomic neuropathy assessment scale SCOPA-AUT score: insomnia codiabetes group is higher than insomnia alone,diabetes alone and control group.Among them,the group with six major autonomic nervous system lesions,insomnia and diabetes mellitus scored higher in the cardiovascular,gastrointestinal,urinary tract,and pupillary regulation system than other groups.(p<0.05).4.In the insomnia disorder combined with diabetes group,Mean HR was higher than that in the insomnia disorder group alone(p<0.05);Frequency domain indexes:low frequency(LF)and low frequency/high frequency(LF/HF)were higher than those in insomnia disorder group(p<0.05).Compared with the increase of LF value,HF value decreases.Univariate linear regression analysis showed that gender,duration of insomnia,fasting blood glucose,HBA1 c,SCOPA-AUT and PSQI were positively correlated with sympathetic index.Gender and PSQI were correlated with parasympathetic index.Conclusion:1.Sleep diary showed that patients with insomnia disorder combined with diabetes had longer time to fall asleep,more time and times of waking at night,and lower sleep efficiency than patients with simple diabetes,simple insomnia disorder and normal control group.2.ISI and PSQI scores showed that patients with insomnia disorder combined with diabetes had more severe insomnia and worse sleep quality than patients with insomnia disorder alone.3.The autonomic neuropathy of patients with insomnia disorder combined with diabetes mellitus is more serious than that of patients with insomnia disorder alone,diabetes alone and normal control group,mainly manifested in cardiovascular,urinary tract and gastrointestinal system.4.The comparison between patients with insomnia disorder and diabetes mellitus and patients with simple insomnia disorder,simple diabetes mellitus and normal control group showed that the sympathetic index was mainly increased and the sympathetic nerve excitation was mainly.