Quantity and Quality of Sleep and Incidence of Type 2 Diabetes

University of Warwick, Warwick Medical School, Clinical Sciences Research Institute, Coventry, UK.
Diabetes care (Impact Factor: 8.42). 11/2009; 33(2):414-20. DOI: 10.2337/dc09-1124
Source: PubMed


To assess the relationship between habitual sleep disturbances and the incidence of type 2 diabetes and to obtain an estimate of the risk.
We conducted a systematic search of publications using MEDLINE (1955-April 2009), EMBASE, and the Cochrane Library and manual searches without language restrictions. We included studies if they were prospective with follow-up >3 years and had an assessment of sleep disturbances at baseline and incidence of type 2 diabetes. We recorded several characteristics for each study. We extracted quantity and quality of sleep, how they were assessed, and incident cases defined with different validated methods. We extracted relative risks (RRs) and 95% CI and pooled them using random-effects models. We performed sensitivity analysis and assessed heterogeneity and publication bias.
We included 10 studies (13 independent cohort samples; 107,756 male and female participants, follow-up range 4.2-32 years, and 3,586 incident cases of type 2 diabetes). In pooled analyses, quantity and quality of sleep predicted the risk of development of type 2 diabetes. For short duration of sleep (< or =5-6 h/night), the RR was 1.28 (95% CI 1.03-1.60, P = 0.024, heterogeneity P = 0.015); for long duration of sleep (>8-9 h/night), the RR was 1.48 (1.13-1.96, P = 0.005); for difficulty in initiating sleep, the RR was 1.57 (1.25-1.97, P < 0.0001); and for difficulty in maintaining sleep, the RR was 1.84 (1.39-2.43, P < 0.0001).
Quantity and quality of sleep consistently and significantly predict the risk of the development of type 2 diabetes. The mechanisms underlying this relation may differ between short and long sleepers.

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    • "Although there is a lack of epidemiologic studies linking long-term noise exposure to overweight or obesity, substantial evidence links noise to a stress response (Babisch 2003; Babisch et al. 2001; Ising and Braun 2000; Ising and Kruppa 2004; Persson Waye et al. 2003; Selander et al. 2009a; Spreng 2000a), and also links chronic stress to impaired metabolic functions (Björntorp and Rosmond 2000; Kyrou and Tsigos 2007; Rosmond 2003, 2005; Rosmond and Björntorp 2000; Spreng 2000b). In addition, noise exposure is commonly associated with sleep disturbances, which are known to have metabolic complications (Cappuccio et al. 2010; Chaput et al. 2007; Spiegel et al. 1999; Taheri et al. 2004; Van Cauter et al. 2008). As mentioned, we found an association between aircraft noise and increases in waist circumference; however, the findings for BMI were not as clear. "
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    Full-text · Article · May 2014 · Environmental Health Perspectives
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    • "Inadequate sleep duration, either in excess or deficit, has been associated with cardiovascular diseases and other non-communicable diseases (NCDs). A meta-analysis of prospective studies reported that either short- or long-sleep duration: (1) is a risk factor for dying of coronary heart disease or stroke (Cappuccio et al., 2011); (2) is associated with hypertension (Guo et al., 2013); (3) is associated with type-2 diabetes (Cappuccio et al., 2010a); (4) is associated with obesity (Marshall, Glozier & Grunstein, 2008). In general, individuals with short- or long-sleep patterns are at higher risk of all cause mortality (Cappuccio et al., 2010b; Gallicchio & Kalesan, 2009); yet, the evidence is not conclusive on this matter (Kurina et al., 2013). "
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