difficulties for including diabetic patients

The primary objectives are to compare the mean levels of the sleep quality parameters of subjects : with a nocturnal fall of the SBP (Systolic blood pressure), DBP (diastolic blood pressure) and MAP (mean arterial pressure) over of egal to 10% (dipping subjects) and of subjects with a nocturnal fall of SBP, DBP and MAP inferior to 10% (non dipper subjects).

The secondary objectives are :

Establish correlations between:

• The quality of sleep parameters
• The parameters of BP variations between the diurnal and nocturnal periods and the awake periods of sleep defined in reference to polysomnography.
• The glycemia levels on 24h with a glycemic holter. The parameters of the sympathic system activation evaluated in reference to the measure of the baroreflex sensibility during the awake period.

It is a prospective monocentric study after a preliminary period of depistage of the sleep abnormalities by oximetry at home. The patient would be hospitalized for two consecutive days (J0, J1). And the following evaluations will be done:

• Nocturnal oxymetric + Epworth questionnaire + clinical questionnaire to detect sleep perturbations at home.
• Blood pressure + heart rate measure
• Ambulatory blood pressure monitoring on 24 hours
• Polysomnographic measurements during the J0-J1 night spend at the hospital.
• Questionnaire of sleep quality and of quality of life.
• Glycemic measurements on 24h (J0-J1).
• Measure of the baroreflex sensibility during the awake period at J1.
• Electrocardiogram
• Biological examinations (blood and urinary).

Inclusion Criteria:

• Male and female patients between 18 and 60 years of age
• Who have given their written consent to participate in this study
• Who are affiliated to the French social security system
• Are able to travel to Grenoble University Hospital
• Type I diabetes in reference to the 1997 criteria (American Diabetes Association) without any recent cetoacidosis or severe hypoglycaemia during the previous month and with a HbA1c < 10% during the previous month.
• Normal blood pressure or essential hypertension light or moderate (SBP) at rest in the sitting position >= 140 mmHg and < 180 mmHg and/or PAD >= 90 mmHg et < 110 mmHg), with or without treatment.

Exclusion Criteria:

• Non stabilised diabetes with at least one episode of acidoketosis decompensation or hypoglycemic coma during the previous month.
• Diabetic nephropathy patent stage 4 with a creatinine > 150 mol / L and / or creatinine clearance <50 ml / min
• Diabetic nephropathy in evolution
• Severe hypertension (SBP at rest in the sitting position >= 180 mmHg and/or DBP >= 110 mmHg)