Association of Self-Reported Sleep and Circadian Measures With Glycemia in Adults With Prediabetes or Recently Diagnosed Untreated Type 2 Diabetes (original) (raw)
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Frontiers in Endocrinology, 2018
Background: Circadian system is known to influence energy metabolism. Recent evidence suggested that evening preference could be associated with higher body mass index (BMI). Moreover, evening preference is known to be associated with insufficient sleep duration and greater social jetlag, both described to be associated with obesity. This study aimed to explore whether morningness-eveningness was directly associated with BMI or its effect was transmitted through sleep duration or social jetlag in patients with prediabetes. Methods: A total 2,133 patients with prediabetes were enrolled. Morningness-eveningness was assessed using a Composite Scale of Morningness (CSM). Average weekly sleep duration and sleep timing were obtained, and social jetlag was calculated. BMI was calculated by weight (kg)/height 2 (m 2). A mediation analysis was performed based on two pathways, i.e. CSM→sleep→duration→BMI and CSM→social jetlag→BMI. A sequential equation model was used to estimate the direct and indirect effects of CSM on BMI. Results: Mean (SD) age and BMI were 63.6 (9.2) years and 25.8 (4.0) kg/m 2. For CSM→sleep duration→BMI pathway, every one point decrease in CSM (more evening preference) was associated with a decrease in sleep duration by 0.054 h (95% CI 0.043-0.066), whereas sleep duration was negatively associated with BMI (coefficient = −0.156, 95%CI −0.288, −0.024). Mediation analysis indicated that a change in CSM (from 90th to 10th percentile, more evening preference) was associated with a decrease in sleep duration and an increase in BMI by 0.102 kg/m 2 (95% CI 0.015, 0.207). In addition, this change in CSM was directly associated with an increase in BMI by 0.511 kg/m 2 (95%CI 0.030, 0.952). The CSM→social jetlag→BMI pathway analysis revealed that social jetlag was not significantly associated with BMI. A subgroup analysis in those aged ≤60 years (n = 784) revealed that each hour increase in social jetlag was associated with an increase in BMI by 0.56 kg/m 2 (p = 0.026) while CSM and sleep duration were not. Anothaisintawee et al. Morningness-Eveningness and BMI in Prediabetes Conclusion: In patients with prediabetes, more evening preference was directly associated with higher BMI and indirectly through insufficient sleep duration, while social jetlag did not mediate the relationship between CSM and BMI. In those ≤60 years, only greater social jetlag was associated with higher BMI. These data could inform further interventional studies to reduce BMI in this high risk group.
Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag
European Journal of Endocrinology, 2016
BackgroundSleep behavior is changing toward shorter sleep duration and a later chronotype. It results in a sleep debt that is acquitted on work-free days, inducing a small but recurrent sleep misalignment each week, referred to as “social jetlag”. These sleep habits could affect health through misalignment with circadian rhythms.ObjectivesThe primary objective is to address the impact of sleep behavior on glycemic control, assessed by HbA1c, in patients with type 1 diabetes, independently of other lifestyle or sleep-related factors. The secondary objective is to address whether circadian phase affects glycemic control.DesignIn total, 80 adult patients with type 1 diabetes (46% female) were included in a clinical cohort study.MethodsSleep behavior was addressed objectively by a 7-day actimetry, lifestyle by questionnaires, sleep breathing disorders by nocturnal oximetry and circadian phase by dim light melatonin onset (DLMO).ResultsUnivariate analyses showed that chronotype (r = 0.23...
Sleep abnormalities in type 2 diabetes may be associated with glycemic control
Acta Diabetologica, 2008
Sleep disturbances may be associated with impaired glucose metabolism. The aim of this study was to evaluate sleep duration and quality in relation to glycemic control in patients with type 2 diabetes. In a cross-sectional study, sleep duration and quality were assessed in 47 middle-aged patients with type 2 diabetes treated with oral agents and without sleep disturbing complications and 23 healthy control subjects similar by age, sex, body mass index, occupation and schooling. Sleep was recorded by wrist-actigraphy for three consecutive days under free-living conditions. Univariate analysis showed lower sleep maintenance (P = 0.002) and sleep efficiency (P = 0.005), and higher fragmentation index (P \ 0.0001), total activity score (P = 0.05) and moving time (P \ 0.0001) in patients with type 2 diabetes. After adjusting for age, gender and schooling, fragmentation index and moving time remained significantly higher in the patients with diabetes (P \ 0.05, both). HbA1c correlated inversely with sleep efficiency (r = -0.29; P = 0.047) and positively with moving time (r = 0.31; P = 0.031). These findings suggest that type 2 diabetes is associated with sleep disruptions even in the absence of complications or obesity. The relevance of sleep abnormalities to metabolic control and possible strategies to improve sleep quality in type 2 diabetes deserve further investigation.
Association of Sleep Time With Diabetes Mellitus and Impaired Glucose Tolerance
Archives of Internal Medicine, 2005
Background: 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 communitybased prospective study of the cardiovascular consequences of sleep-disordered breathing.
Sleep, 2015
A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact of sleep/circadian disruption in humans to move beyond measurements of insulin and glucose and conduct more in-depth phenotyping. There is also a need for the assessments of sleep and circadian rhythms as well as assessments for sleep-disordered breathing to be incorporated into all ongoing cohort studies related to diabetes risk. Studies in hum...
Nature and Science of Sleep, 2012
Some studies have found an association between sleep disturbances and metabolic risk, but none has examined this association in individuals with type 2 diabetes. The objective of this study was to determine the relationship between sleep disturbances and metabolic risk factors in obese patients with type 2 diabetes. Patients and methods: This study was a cross-sectional examination of the relationship between sleep parameters (apnea/hypopnea index [AHI], time spent in various sleep stages) and metabolic risk markers (fasting glucose, hemoglobin A 1c , lipids) using baseline data of the Sleep AHEAD cohort. Subjects (n = 305) were participants in Sleep AHEAD (Action for Health in Diabetes), a four-center ancillary study of the Look AHEAD study, a 16-center clinical trial of overweight and obese participants with type 2 diabetes, designed to assess the long-term effects of an intensive lifestyle intervention on cardiovascular events. All participants underwent one night of in-home polysomnography and provided a fasting blood sample. Regression analyses estimated the relationship between sleep variables and metabolic risk factors. Models were adjusted for study center, age, sex, race/ethnicity, waist circumference, smoking, alcohol intake, diabetes duration, and relevant medications. Results: Of 60 associations tested, only one was significant: fasting glucose was associated with sleep efficiency (estimate −0.53 ± [standard error] 0.26, P = 0.041). No associations were found between any of the sleep variables and lipid profile or hemoglobin A 1c. Conclusions: The present data show only weak associations between select sleep variables and metabolic risk factors and do not provide strong support for a role of sleep on metabolic abnormalities in obese patients with type 2 diabetes.
Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes
Sleep Medicine, 2015
Objective: To examine the association between sleep duration and cardiometabolic risk factors among individuals with recently diagnosed type 2 diabetes (n = 391). Methods: Sleep duration was derived using a combination of questionnaire and objective heart rate and movement sensing in the UK ADDITION-Plus study (2002)(2003)(2004)(2005)(2006)(2007). Adjusted means were estimated for individual cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) by five categories of sleep duration. Results: We observed a J-shaped association between sleep duration and CCMR -individuals sleeping 7 to <8 h had a significantly better CCMR profile than those sleeping ≥9 h. Independent of physical activity and sedentary time, individuals sleeping 7 to <8 h had lower triacylglycerol (0.62 mmol/l (0.29, 1.06)) and higher high-density lipoprotein (HDL)-cholesterol levels (0.23 mmol/l (0.16, 0.30)) compared with those sleeping ≥9 h, and a lower waist circumference (7.87 cm (6.06, 9.68)) and body mass index (BMI) (3.47 kg/m 2 (2.69, 4.25)) than those sleeping <6 h. Although sleeping 7 to <8 h was associated with lower levels of systolic and diastolic blood pressure, HbA1c, total cholesterol, and low-density lipoprotein (LDL)cholesterol, these associations were not statistically significant. Conclusions: Sleep duration has a J-shaped association with CCMR in individuals with diabetes, independent of potential confounding. Health promotion interventions might highlight the importance of adequate sleep in this high-risk population. Please cite this article in press as: Andrew J.M. Cooper, et al., Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes, Sleep Medicine (2014), Values are expressed as means (SD) unless stated otherwise. p values are from p trend, Kruskal-Wallis and chi-squared tests, as appropriate. Abbreviations: IQR = interquartile range. PAEE = physical activity energy expenditure. ARTICLE IN PRESS Please cite this article in press as: Andrew J.M. Cooper, et al., Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes, Sleep Medicine (2014), Please cite this article in press as: Andrew J.M. Cooper, et al., Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes, Sleep Medicine (2014), Please cite this article in press as: Andrew J.M. Cooper, et al., Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes, Sleep Medicine (2014),
Current Diabetes Reports, 2020
Purpose of Review Night-tonight variability in sleep patterns leads to circadian disruption and, consequently, could increase cardiometabolic risk. The purpose of this review is to summarize findings from studies published between 2015 and 2020 examining various measures of night-tonight variability in sleep in relation to metabolic syndrome (MetS), type 2 diabetes (T2D), and their risk factors. We illustrate a potential causal pathway between irregular sleep patterns and T2D, highlighting knowledge gaps along the way. Recent Findings Across different measures of sleep variability, irregular sleep patterns were associated with poorer cardiometabolic outcomes. Higher standard deviations (SD) across nights of sleep duration and onset or midpoint of sleep were associated with increased odds of having MetS and clusters of metabolic abnormalities as well as greater adiposity and poorer glycemic control. Conversely, greater regularity of rest-activity patterns related to lower risk for T2D. Social jetlag was associated with glycemic dysregulation, adiposity, T2D, and MetS. These associations are often observed in both metabolically healthy and unhealthy individuals; both higher SD of sleep duration and social jetlag relate to poorer glucose regulation in individuals with diabetes. Summary There is consistent evidence of associations of sleep variability with increased risk for adiposity, glucose dysregulation, T2D, and MetS. Although experimental evidence is needed to determine causation, there is support to recommend stabilizing sleep patterns for cardiometabolic risk prevention.
Sleep duration is a potential risk factor for newly diagnosed type 2 diabetes mellitus
Metabolism, 2011
U-shaped patterns have been observed for the relationship between sleep duration and diabetes. In addition, prediabetes is associated with the risk of cardiovascular diseases and diabetes. However, there are few studies investigating the relationship between sleep duration and prediabetes/newly diagnosed diabetes. The aim of this study is to examine the relationship between sleep duration and prediabetes/ newly diagnosed diabetes in a Taiwanese population. After excluding the subjects with a high risk of obstructive sleep apnea, those with a positive history of diabetes, or those taking hypnotic drugs, a total of 3470 adults were recruited from a health checkup center. Each subject completed a self-administrated structured questionnaire on sleep duration and lifestyle factors. Prediabetes/diabetes was defined following the definition of the American Diabetes Association. Subjects with different sleep durations were classified into short (b6.0 hours), normal (6.0∼8.49 hours), and long sleepers (≥8.5 hours). The proportion of subjects with normal glucose tolerance, prediabetes, and newly diagnosed diabetes was 71.9%, 22.9%, and 5.2%, respectively. There were significant differences in age, sex, weight, education level, body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, alcohol and coffee drinking habits, family history of diabetes, and sleep duration among the 3 glycemic groups. In multinomial regression, both short and long sleepers had a higher risk of newly diagnosed diabetes; and the odds ratio were 1.55 (95% confidence interval, 1.07-2.24) and 2.83 (1.19-6.73), respectively. However, sleep duration was not found to relate to prediabetes. In conclusion, both short and long sleep durations were independently associated with newly diagnosed diabetes, but not with prediabetes.
Association of short sleep duration with impaired glucose tolerance or diabetes mellitus
Journal of diabetes investigation, 2011
Aims/Introduction: To examine the cross-sectional relationship between sleep duration and impaired glucose tolerance (IGT), including diabetes mellitus (DM), we analyzed a large-scale healthy workers database in Japan. We examined the baseline database of 4143 participants (3415 men and 728 women) aged 19-69 years. Sleep duration of participants was categorized into four groups: <6, 6 to <7, 7 to <8 and ≥8 h. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined IGT including DM (IGT/DM) in the present study according to previous studies as follows: fasting blood sugar level ≥110 mg/dL, or if <8 h after meals ≥140 mg/dL, or on medication for diabetes mellitus, or those diagnosed as having DM. Logistic regression was applied to estimate the odds ratio (OR) to examine the relationship between IGT/DM, sleep duration and other related factors. The number of participants with IGT/DM was ...