Sleep Disturbances May be Common in Adults With Maturity-Onset Diabetes of the Young

According to researchers who published their findings in Diabetes Care, patients with maturity-onset diabetes of the young (MODY) may also suffer from sleep disturbances, despite a lack of traditional risk factors for sleep disorders in this population.

Researchers conducted a quantitative cross-sectional study to measure the prevalence of sleep disturbances among those with MODY. The two most common subtypes of MODY were assessed: glucokinase (GCK)-MODY and transcription factor (TF)-related MODY (HNF1A, HNF1B, HNF4A). 

A total of 24 participants were recruited from the University of Chicago’s Monogenic Diabetes Registry from June to December 2022. Patients were excluded if they were younger than 18 years, were pregnant, had known neurodevelopmental disorders, or were diagnosed with or treated for sleep disorders. All assessments were conducted in the participants’ homes.

The participants used a 2-week wrist actigraphy for 315 nights and took 1 night home sleep apnea test, both of which were used to measure objective sleep patterns. A total of 3 validated sleep quality surveys were used to quantify subjective sleep quality. Sleep was automatically scored using validated algorithms, and mean sleep duration percentile of actigraphy data for each participant was used to quantify night-to-night variability in sleep patterns. 

Compared with established criteria for sleep disturbances, 29% of participants presented with a sleep latency of 15 minutes or more. In addition, 38% of study participants had sleep efficiency less than or equal to 85%, while 46% of participants had wake after sleep onset of more than 40 minutes. The researchers concluded that this data indicates poor objective sleep quality. In comparing participants with GCK-MODY and TF-related MODY, those with TF-related MODY had significantly longer sleep latency, poorer sleep efficiency, and more sleep fragmentation. These patients also had greater night-to-night variability for sleep efficiency, sleep duration, sleep latency, and wake after sleep onset.

Of the participants, 58% were found to have obstructive sleep apnea (OSA), with 64% presenting with mild OSA, 22% with moderate, and 14%, severe. There was no significant link found between the severity of OSA and BMI or age. In addition, there was no significant difference in OSA between those with GCK-MODY and TF-related MODY. Researchers also found that 54% of the participants had a sleep duration below the recommended minimum of 7 hours. 

Study limitations include no control group, small sample size—especially for GCK-MODY—as well as study population being recruited from only the most common subtypes of MODY. In addition, the researchers believe there to be a self-selection bias, as those who agreed to participate in the study likely had greater sleep disturbances. This may limit generalizability of the findings. They also estimate that there may be an underreporting of sleep disturbances as it was an exclusion criteria for the study. The researchers noted that their findings warrant future rigorous investigations regarding underlying pathophysiology and MODY.

The authors concluded “Compared with participants with GCK-MODY, those with TF-related MODY had poorer objective sleep quality, greater sleep variability, and a higher resting heart rate, all of which have been associated with adverse cardiometabolic outcomes.”