OBJECTIVE -To study the relation between diabetes incidence and sleep problems in a population-based sample of women followed for 32 years.RESEARCH DESIGN AND METHODS -The researchers conducted a prospective population study initiated in 1968 -1969, with follow-ups in 1974 -1975, 1980-1981, 1992-1993 in Gothenburg, Sweden. A total of 1,462 women born in 1908, 1914, 1918, 1922, and 1930, representative of women of the same ages in the general population, initially participated (90% participation rate). Reported sleep duration, sleep problems, and use of sleeping medication were related to incident diabetes from 1968 to 2000. Associations between sleep problems and diabetes were corrected for waist-to-hip ratio (WHR), BMI, subscapular skinfold, fasting blood glucose and serum lipid concentrations, blood pressure, heart rate, smoking, physical activity, education, and socioeconomic status. Additionally, associations between BMI, WHR, and sleep problems were examined.RESULTS -Over 32 years, 126 women (8.7%) developed diabetes. Associations between diabetes and initial sleep problems were tested in a Cox regression analysis, taking into consideration factors associated (P Ͻ 0.1) with diabetes. Sleep problems in 1968 did not increase risk of developing diabetes during the following 32 years. Obesity, particularly centralized, was associated with sleep problems.CONCLUSIONS -No association between sleep problems and developing diabetes was seen in this 32-year follow-up of middle-aged women. Obesity, on the other hand, known to cause increased risk of diabetes, was associated with current sleep problems. Diabetes Care 28:2739 -2744, 2005I nsomnia is becoming increasingly common (1). Stressful life events, mediated by personal vulnerability, have been found to be closely related to the onset of chronic insomnia (1,2). The current prevalence of insomnia varies in different population studies and depends on the definition used. When asked about insomnia problems, 26% of American older adults (1) and 38% of adults in Finland (3) reported insomnia. On the other hand, using the Diagnostic and Statistical Manual of Mental Disporders, Fourth Edition insomnia diagnosis yielded a prevalence rate of 12% in both Norway and Finland (3,4). The predisposition to insomnia increases with age (5-7) and somatic health status, although women show a more inconsistent relationship (4,6). Sleeping difficulty including insomnia is a common complaint among older women and is associated with use of sleeping medications (4,6 -8).The question of whether insomnia and other sleep problems can specifically contribute to type 2 diabetes has been much debated in recent years, as diabetes becomes an urgent worldwide public health concern. Insulin resistance may be induced via psychoneuroendocrine mechanisms and by disruption of the hypothalamic-pituitary-adrenal (HPA) axis (9). The HPA axis is a major component of the stress system, and dysfunction of the HPA axis leads to elevated levels of circulating cortisol. Further hypercortisolemia results in m...

Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.