Association of Sleep Time With Diabetes Mellitus and Impaired Glucose Tolerance

The Pulmonary Center, Boston University School of Medicine, VA Boston Healthcare System, 715 Albany St, Mail Stop R-304, Boston, MA 02118, USA.
Archives of Internal Medicine (Impact Factor: 17.33). 05/2005; 165(8):863-7. DOI: 10.1001/archinte.165.8.863
Source: PubMed


Experimental sleep restriction causes impaired glucose tolerance (IGT); however, little is known about the metabolic effects of habitual sleep restriction. We assessed the cross-sectional relation of usual sleep time to diabetes mellitus (DM) and IGT among participants in the Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing.
Participants were 722 men and 764 women, aged 53 to 93 years. Usual sleep time was obtained by standardized questionnaire. Diabetes mellitus was defined as a serum glucose level of 126 mg/dL or more (> or =7.0 mmol/L) fasting or 200 mg/dL or more (> or =11.1 mmol/L) 2 hours following standard oral glucose challenge or medication use for DM. Impaired glucose tolerance was defined as a 2-hour postchallenge glucose level of 140 mg/dL or more (> or =7.8 mmol/L) and less than 200 mg/dL. The relation of sleep time to DM and IGT was examined using categorical logistic regression with adjustment for age, sex, race, body habitus, and apnea-hypopnea index.
The median sleep time was 7 hours per night, with 27.1% of subjects sleeping 6 hours or less per night. Compared with those sleeping 7 to 8 hours per night, subjects sleeping 5 hours or less and 6 hours per night had adjusted odds ratios for DM of 2.51 (95% confidence interval, 1.57-4.02) and 1.66 (95% confidence interval, 1.15-2.39), respectively. Adjusted odds ratios for IGT were 1.33 (95% confidence interval, 0.83-2.15) and 1.58 (95% confidence interval, 1.15-2.18), respectively. Subjects sleeping 9 hours or more per night also had increased odds ratios for DM and IGT. These associations persisted when subjects with insomnia symptoms were excluded.
A sleep duration of 6 hours or less or 9 hours or more is associated with increased prevalence of DM and IGT. Because this effect was present in subjects without insomnia, voluntary sleep restriction may contribute to the large public health burden of DM.

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Available from: Carol M Baldwin, Dec 31, 2014
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    • "This increased risk is linked to cognitive deficits associated with impaired glycemic control in T2DM (Cukierman- Yaffe et al., 2009). Over the last decade, compelling evidence has identified disrupted sleep as an independent T2DM risk factor (Gottlieb et al., 2005; Knutson et al., 2006, 2007; Laposky et al., 2008; Gale et al., 2011; Touma and Pannain, 2011; Wan Mahmood et al., 2013), contributing to diabetes progression (Gale et al., 2011) and severity (Knutson et al., 2007). Poor sleep quality (as measured by the Pittsburgh Sleep Quality Index; PSQI) is predictive of higher levels of hemoglobin-A1c (HbA1c; Knutson et al., 2007; Wan Mahmood et al., 2013), which is the gold standard for indexing glycemic control and diabetes selfmanagement (Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, 2013). "
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    Frontiers in Aging Neuroscience 12/2014; 6:325. DOI:10.3389/fnagi.2014.00325 · 4.00 Impact Factor
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    • "Recent research has identified sleep quality and sleep duration as important factors in cardiovascular disease risk [Buxton and Marcelli, 2010; Laugsand et al., 2013]. Indeed, insufficient sleep duration and poor sleep quality appear to contribute to increased cardiovascular disease risk [Buxton and Marcelli, 2010; Cappuccio et al., 2010], and have been linked to elevated body mass index [Hasler et al., 2004; Kohatsu et al., 2006], weight gain [Patel et al., 2004, 2008], obesity [Taheri et al., 2004; Cizza et al., 2005; Gangwisch et al., 2005; Buxton et al., 2013], and diabetes mellitus [Ayas et al., 2003a; Gottlieb et al., 2005; Buxton et al., 2013]. "
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    American Journal of Industrial Medicine 08/2014; 57(8). DOI:10.1002/ajim.22340 · 1.74 Impact Factor
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    • "Multiple studies have reported that shorter and longer than optimal sleep are both associated with increased obesity, diabetes and other morbidities related to energy balance (Buxton and Marcelli, 2010; Gangwisch et al., 2005). Physical activity could mediate the effects of sleep on energy balance related health outcomes (Atkinson and Davenne, 2007; Basner et al., 2007; Gottlieb et al., 2005). In a recent review , shorter sleep duration was associated with increased obesity risk in five out of five longitudinal studies that controlled for self-reported PA (Patel and Hu, 2008). "
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