Author(s)

Miki Sato, Yuko Yasuhara, Tetsuya Tanioka, Yukie Iwasa, Toshiyuki Yasui, Masafumi Miyake, Haruo Kobayashi, Waraporn Kongsuwan, Rozzano C. Locsin

Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, USA.
Department of Medical Nursing, Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand.
Department of Nursing, Faculty of Nursing, Shikoku University, Tokushima, Japan.
Department of Nursing, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Faculty of Medical Welfare, Kawasaki University of Medical Welfare, Kurashiki, Japan.
Tokushima Prefectural Minami Health Care Center, Tokushima, Japan.

The purpose of this case study was to examine the changes before and after improvements of the subjective sleep status of Mr A, a 40-year-old man diagnosed with pre-diabetes and a sleep disorder. Data were collected using a Holter monitor for 24 hours a day for 3 days to assess autonomic nervous activity by recording bed-time and waking time activity (activity counts: ACs). Mr. A kept a diary of activities and completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The study revealed that subjective sleeping hours correlated almost precisely with those measured by the actigraph and as described in the diary. Both the parasympathetic and sympathetic nervous system activities were imbalanced. However, no correlation was observed between the ACs and autonomic nervous activity. Subjective sleep state according to the PSQI score improved remarkably by dietary and exercise therapy from 13 to 3 points, after six months, with corresponding high level sleep satisfaction level. Significant correlations were observed between ACs and high-frequency spectral power of R-R intervals, and between ACs and the low-frequency/high frequency ratio of spectral power of R-R intervals. Although Mr. A’s sleep satisfaction level has improved, the autonomic nervous system activity remained different from that of healthy people.

Actigraphy; Heart Rate Variability; Autonomic Nervous System; Function; Disturbed sleep; Pre-Diabetes

Sato, M. , Yasuhara, Y. , Tanioka, T. , Iwasa, Y. , Yasui, T. , Miyake, M. , Kobayashi, H. , Kongsuwan, W. and C. Locsin, R. (2013) Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder. Health, 5, 504-511. doi: 10.4236/health.2013.53A069.