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 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- 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
-
Dopamine: The Forgotten Felon in Type 2 Diabetes
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Targeting Drugs to APJ Receptor: The Prospect of Treatment of Hypertension and Other Cardiovascular Diseases
Current Drug Targets Hypertension in Hemodialysis Patients
Current Hypertension Reviews The Potential Role of Sirtuins Regarding the Effects of Exercise on Aging- Related Diseases
Current Aging Science COVID-19: The Significance of Platelets, Mitochondria, Vitamin D, Serotonin and the Gut Microbiota
Current Medicinal Chemistry Proteomic and Bioinformatic Analysis of Trypanosoma cruzi Chemotherapy and Potential Drug Targets: New Pieces for an Old Puzzle
Current Drug Targets New Therapeutic Aspects of Inflammatory Cardiomyopathy
Current Pharmaceutical Design Ex Vivo and In Vivo Approaches to Study Mechanisms of Cardioprotection Targeting Ischemia/Reperfusion (I/R) Injury: Useful Techniques for Cardiovascular Drug Discovery
Current Drug Discovery Technologies Tomographic Imaging Methods and Gated Technique in Nuclear Cardiology: A Review on Current Status and Future Developments
Recent Patents on Medical Imaging Metformin and Energy Metabolism in Breast Cancer: From Insulin Physiology to Tumour-initiating Stem Cells
Current Molecular Medicine Targeting Transient Receptor Potential Channels in Cardiometabolic Diseases and Myocardial Ischemia Reperfusion Injury
Current Drug Targets Mechanisms of Intimal Hyperplasia Learned from a Murine Carotid Artery Ligation Model
Current Vascular Pharmacology Gender Specific Aspects of Cell Death in the Cardiovascular System
Current Pharmaceutical Design Editorial: Modifying Cardiovascular Risk Factors: Acquired Topics and Emerging Concepts
Current Pharmaceutical Design Abnormal Insulin Signaling: Early Detection of Silent Coronary Artery Disease-Erectile Dysfunction?
Current Pharmaceutical Design Reactive Oxygen Species and Antioxidants in the Pathophysiology of Cardiovascular Disease: Does the Actual Knowledge Justify a Clinical Approach?
Current Vascular Pharmacology Cardiovascular Complications of HIV Infection and Treatment
Cardiovascular & Hematological Agents in Medicinal Chemistry Diagnostic Cardiac Catheterization in the Pediatric Population
Current Cardiology Reviews Understanding and Avoiding Antiretroviral Adverse Events
Current Pharmaceutical Design Pharmacology of TRP Channels in the Vasculature
Current Vascular Pharmacology