Abstract
The mechanism of dead-in-bed syndrome (DBS), a rare but devastating condition that mainly affects young type 1 diabetes patients, remains mysterious. A new theory is proposed to explain this syndrome. This theory suggests that repeated episodes of hypoglycaemia-induced adaptation in orexin-A neurons cause (i) defective awakening and (ii) hypotonia of upper airway muscles during sleep. Consequently, due to the combined effect of these factors, long-term exposure of intermittent hypoxia occurs, leading to a combination of factors - such as depression of ventilation, increase in sympathetic tone, fluctuations in intrathoracic pressure and cardiac arrhythmias - these in conjunction with an underlying cardiovascular pathology (genetically inherited or acquired) cause cardio-respiratory failure and thus sudden death during sleep. This mechanism can be generalized to explain other cases of sudden unexplained nocturnal deaths including sudden infant deaths (SIDs).
Keywords: Hypoglycaemia, Glucose, Orexin, Arousal, Sleep apnoea, Sudden death
Current Diabetes Reviews
Title: The Mechanism of Dead-in-Bed Syndrome and Other Sudden Unexplained Nocturnal Deaths
Volume: 5 Issue: 4
Author(s): B. Parekh
Affiliation:
Keywords: Hypoglycaemia, Glucose, Orexin, Arousal, Sleep apnoea, Sudden death
Abstract: The mechanism of dead-in-bed syndrome (DBS), a rare but devastating condition that mainly affects young type 1 diabetes patients, remains mysterious. A new theory is proposed to explain this syndrome. This theory suggests that repeated episodes of hypoglycaemia-induced adaptation in orexin-A neurons cause (i) defective awakening and (ii) hypotonia of upper airway muscles during sleep. Consequently, due to the combined effect of these factors, long-term exposure of intermittent hypoxia occurs, leading to a combination of factors - such as depression of ventilation, increase in sympathetic tone, fluctuations in intrathoracic pressure and cardiac arrhythmias - these in conjunction with an underlying cardiovascular pathology (genetically inherited or acquired) cause cardio-respiratory failure and thus sudden death during sleep. This mechanism can be generalized to explain other cases of sudden unexplained nocturnal deaths including sudden infant deaths (SIDs).
Export Options
About this article
Cite this article as:
Parekh B., The Mechanism of Dead-in-Bed Syndrome and Other Sudden Unexplained Nocturnal Deaths, Current Diabetes Reviews 2009; 5 (4) . https://dx.doi.org/10.2174/157339909789804387
DOI https://dx.doi.org/10.2174/157339909789804387 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Renin--Angiotensin System Gene Polymorphism and Regression of Left Ventricular Hypertrophy in Hypertension
Current Pharmacogenomics Sex Differences in Biomarkers for Predicting Cardiovascular and Coronary Events
Current Vascular Pharmacology Virus-Associated Vasculitides: An Update
Current Immunology Reviews (Discontinued) Pharmacological Therapy in Children with Atrial Fibrillation and Atrial Flutter
Current Pharmaceutical Design The Metabolic Syndrome and the Relevance of Nutrients for its Onset
Recent Patents on Biotechnology Epsilon Waves as an Extreme Form of Depolarization Delay: Focusing on the Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
Current Cardiology Reviews Combating Neurodegenerative Diseases with the Plant Alkaloid Berberine: Molecular Mechanisms and Therapeutic Potential
Current Neuropharmacology Treatment Strategies Against Diabetic Foot Ulcer: Success so Far and the Road Ahead
Current Diabetes Reviews The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease
Current Cardiology Reviews Novel Therapeutic Targets for Phosphodiesterase 5 Inhibitors: current state-of-the-art on systemic arterial hypertension and atherosclerosis
Current Pharmaceutical Biotechnology Patent Selections:
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Cannabinoids and Myocardial Ischemia: Novel insights, Updated Mechanisms, and Implications for Myocardial Infarction
Current Medicinal Chemistry Iatrogenic QT Abnormalities and Fatal Arrhythmias: Mechanisms and Clinical Significance
Current Cardiology Reviews Simultaneous Spectrophotometric Determination of Iron (III) and Vanadium (V) in Water Samples Using a Combination of Partial Least Squares Regression and Solid Phase Extraction with Modified Octadecyl Silica Membrane Disks
Current Analytical Chemistry Mending a Broken Heart: Bioengineered Patches and Scaffolds for Cardiac Repair
Recent Patents on Biomedical Engineering (Discontinued) Normal Ventricular Functional Reference Parameters on Magnetic Resonance Imaging in Healthy Children
Current Medical Imaging IRAKs: Key Regulatory Kinases of Innate Immunity
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents Developing Histone Deacetylase Inhibitors as Anti-Cancer Therapeutics
Current Medicinal Chemistry Tetralogy of Fallot and Hypoplastic Left Heart Syndrome – Complex Clinical Phenotypes Meet Complex Genetic Networks
Current Genomics Role of Methylglyoxal in Diabetic Cardiovascular and Kidney Diseases: Insights from Basic Science for Application into Clinical Practice
Current Pharmaceutical Design