Change in Sleep Duration and Type 2 Diabetes: The Whitehall II Study

Abstract

Objective Evidence suggests that short and long sleep are associated with a higher risk of type 2 diabetes. Using successive data waves spanning more than 20 years we examined whether a change in sleep duration is associated with incident diabetes. Research Design and Methods Sleep duration was reported at the beginning and end of four 5-year cycles: 1985-88 to 1991-94 (N=5613); 1991-94 to 1997-99 (N=4193); 1997-99 to 2002-04 (N=3840); 2002-04 to 2007-09 (N=4195). At each cycle, change in sleep duration was calculated for participants without diabetes. Incident diabetes at the end of the subsequent 5-year period was defined using: (1) fasting glucose; (2) 75g oral glucose tolerance test; and (3) glycated hemoglobin, in conjunction with diabetes medication and self-reported doctor diagnosis. Results Compared to the reference group of persistent 7-hour sleepers, an increase of ≥2hours sleep per night was associated with a higher risk of incident diabetes; Odds Ratios (95% Confidence Intervals) 1.65 (95% CI: 1.15, 2.37), in analyses adjusted for age, sex, employment grade and ethnic group. This association was partially attenuated by adjustment for body mass index and change in weight; 1.50 (1.04, 2.16). An increased risk of incident diabetes was also seen in persistent short sleepers (average ≤5.5 hours/night); 1.35 (1.04, 1.76), but this evidence weakened on adjustment for body mass index and change in weight; 1.25 (0.96, 1.63). Conclusion This study suggests that individuals whose sleep duration increases are at an increased risk of type 2 diabetes. Greater weight and weight gain in this group partly explain the association.

Long-term changes in sleep duration, energy balance and risk of type 2 diabetes

“…This is consistent with our finding that changes in diet quality and physical activity do not explain associations of change in sleep duration with subsequent diabetes. Weight gain operates differently: in both our study and in Whitehall II [25], weight gain explained the relationship between chronic short sleep duration and diabetes but not the relationship between increases of ≥2 h/day and diabetes. One potential explanation is that measurement error masks mediation by diet and activity but is less of a concern for weight assessment.…”

“…Whitehall II is the only other study to examine changes in sleep duration (over ~5 years) and subsequent diabetes [25]. Although key confounders and intermediates including shift work, sleep apnoea, snoring, depression, diet quality and physical activity were not measured in Whitehall II, the results were strikingly similar to those in our study: compared with consistent 7 h sleepers, both consistently short sleep (≤5.5 h/night; OR [95%CI]: 1.35 [1.04, 1.76]) and increases of ≥2 h/night (1.65 [1.15, 2.37]) were adversely associated with diabetes.…”

Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus

“…Sleep is a basic biological need that, when disturbed, is associated with metabolic disease risk (1)(2)(3)(4)(5)(6), including diabetes mellitus (7,8). The present guidelines recommend 7-8 h of sleep within a 24-h period for adults to 2 Author disclosures: A Bermúdez-Millán, R Pérez-Escamilla, S Segura-Pérez, G Damio, J Chhabra, CY Osborn, and J Wagner, no conflicts of interest.…”

Bromocriptine-QR therapy for the management of type 2 diabetes mellitus: developmental basis and therapeutic profile summary

“…While such a circadian-based hypothalamic neurochemistry provides for survival against low/no food availability in a seasonal natural environment setting via CNS seasonal control mechanisms, the annual persistence of this neurochemical organization precipitated by the persistent presence of the westernized diet (as discussed above) (or westernized lifestyle -including stress and/or altered sleep/ wake cycle) as in the human condition potentiates metabolic disease. Several studies have now documented that alterations to daily sleep (either shortened sleep [<5. insulin resistance and IRS (postprandial hyperglycemia, increased sympathetic tone, inflammation, and reactive oxygen species generation) and are associated with increased risk for cardiovascular disease (CVD) [105][106][107][108]. Moreover, stress identified by hypercortisolemia is also coupled with such increased risk for metabolic and CVD [109][110][111].…”