Uyku bozuklukları, diyabet ve obezite

Öz

Uyku, zihinsel ve metabolik süreçlerin yoğun olduğu, yaşam için vazgeçilmez bir süreçtir. Sanayileşme ile başlayan modern yaşam, uyku süresinin azalmasına, uyku bozuklukları ve buna bağlı diyabet ile obezite gibi kronik hastalıkların artırmasına neden olmaktadır. Bu derleme, uyku bozukluklarının diyabet ve obeziteyle ilişkisini irdelemeyi amaçlamaktadır. Uyku, non-REM ve REM evrelerinden oluşur; non-REM metabolik restorasyonu, REM ise daha çok bilişsel işlevleri destekler. Uyku-uyanıklık döngüsü, sirkadiyen ve homeostatik sistemlerle düzenlenir. Uykunun süresini ve kalitesini bozan faktörler, birçok metabolik hastalığın riskini artırırken, obezite ve diyabet gibi kronik hastalıklarda uyku bozuklukları daha sık görülebilmektedir. Uyku süresinin azalması ve kalitesinin bozulması, glukoz metabolizmasını olumsuz etkileyerek insülin direnci, prediyabet ve tip 2 diyabet riskini artırır. Ayrıca leptin düşüşü ve ghrelin artışı üzerinden iştahı artırarak kilo alımına neden olur. Türkiye’de güncel verilere göre diyabet sıklığı %15,9, obezite sıklığı ise %20.2’dir. Günlük uyku süresinde 1 saat azalma bile, 10 yıllık diyabet gelişim riskini %3 artırabilir. İnsomnia, diyabet riskini 2,88 kat artırır, ayrıca diyabetik bireylerde HbA1c ve açlık glisemisini yükseltir. Obstrüktif uyku apne sendromu (OSAS), VKİ ≥ 30 kg/m2 bireylerin %60’ında görülür ve kilo artışı ile şiddetlenir. Ayrıca diyabet riskini %35-49 oranında artırır ve diyabetlilerin %90’ında görülen obeziteyle ilişkilidir. Huzursuz bacak sendromu, diyabetlilerde 4 kat sık görülür ve insülin direncini tetikler. Vardiyalı çalışma ise diyabet riskini %22-40, obezite riskini ise %17 artırır. Sonuç olarak uyku bozuklukları başta diyabet ve obezite olmak üzere pek çok metabolik hastalık ile ilişkilidir. Metabolik hastalıkların tedavi ve yönetiminde başarılı olabilme hastanın kapsamlı değerlendirilmesi ve tedavisi ile doğrul orantılıdır. Bu nedenle kronik hastalık yönetimi mutlaka uyku değerlendirmesini de içermelidir.

Anahtar Kelimeler

• uyku bozuklukları
• diyabet
• obezite
• metabolik hastalık

Sleep disorders, diabetes and obesity

Öz

Sleep is an indispensable process for life, characterized by intense mental and metabolic activity. Modern life, ushered in by industrialization, has reduced sleep duration, leading to an increase in sleep disorders and related chronic conditions such as diabetes and obesity. This review aims to examine the relationship between sleep disorders, diabetes, and obesity. Sleep consists of non-REM and REM stages; non-REM supports metabolic restoration, while REM primarily aids cognitive functions. The sleep-wake cycle is regulated by circadian and homeostatic systems. Factors disrupting sleep duration and quality heighten the risk of various metabolic diseases, with sleep disorders being more prevalent in chronic conditions like obesity and diabetes. Reduced sleep duration and impaired sleep quality negatively affect glucose metabolism, increasing the risk of insulin resistance, prediabetes, and type 2 diabetes. Additionally, it boosts appetite through decreased leptin and increased ghrelin levels, contributing to weight gain. According to current data from Türkiye, the prevalence of diabetes is 15.9%, and obesity is 20.2%. Even a 1-hour reduction in daily sleep can increase the 10-year risk of developing diabetes by 3%. Insomnia raises diabetes risk by 2.88 times and elevates HbA1c and fasting glucose levels in diabetic individuals. Obstructive sleep apnea syndrome (OSAS) occurs in 60% of individuals with a BMI ≥ 30 kg/m², worsening with weight gain. It also increases diabetes risk by 35-49% and is linked to obesity, present in 90% of diabetics. Restless legs syndrome, seen four times more frequently in diabetics, exacerbates insulin resistance. Shift work increases diabetes risk by 22-40% and obesity risk by 17%. In conclusion, sleep disorders are closely associated with metabolic diseases, particularly diabetes and obesity. Successful treatment and management of these conditions are directly proportional to a comprehensive patient evaluation and treatment plan. Therefore, chronic disease management must include an assessment of sleep health.

Anahtar Kelimeler

• sleep disorders
• diabetes
• obesity
• metabolic disease

Kaynakça

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