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Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus.

Abstract

BACKGROUND

Evidence from laboratory and epidemiologic studies suggests that decreased sleep duration or quality may increase diabetes risk. We examined whether short or poor sleep is associated with glycemic control in African Americans with type 2 diabetes mellitus.

METHODS

We conducted a cross-sectional study of volunteers with type 2 diabetes interviewed at the University of Chicago Hospitals, Chicago, Ill. The final analysis included 161 participants. Glycemic control was assessed by hemoglobin A1c (HbA1c) level obtained from medical charts. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Perceived sleep debt was calculated as the difference between preferred and actual weekday sleep duration.

RESULTS

The mean +/- SD sleep duration was 6.0 +/- 1.6 hours, and 71% of the participants were classified as having poor quality sleep (PSQI score >5). We excluded patients with sleep frequently disrupted by pain (n = 39). In patients without diabetic complications, glycemic control was associated with perceived sleep debt but not PSQI score. The predicted increase in HbA1c level for a perceived sleep debt of 3 hours per night was 1.1% above the median. In patients with at least 1 complication, HbA1c level was associated with PSQI score but not perceived sleep debt. The predicted increase in HbA1c level for a 5-point increase in PSQI was 1.9% above the median.

CONCLUSIONS

In our sample, sleep duration and quality were significant predictors of HbA1c, a key marker of glycemic control. Combined with existing evidence linking sleep loss to increased diabetes risk, these data suggest that optimizing sleep duration and quality should be tested as an intervention to improve glucose control in patients with type 2 diabetes.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, University of Chicago, Chicago, IL 60637, USA.

    , ,

    Source

    Archives of internal medicine 166:16 2006 Sep 18 pg 1768-74

    MeSH

    African Continental Ancestry Group
    Cross-Sectional Studies
    Diabetes Mellitus, Type 2
    Female
    Glycated Hemoglobin A
    Humans
    Male
    Middle Aged
    Regression Analysis
    Risk Factors
    Severity of Illness Index
    Sleep
    Surveys and Questionnaires
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16983057

    Citation

    Knutson, Kristen L., et al. "Role of Sleep Duration and Quality in the Risk and Severity of Type 2 Diabetes Mellitus." Archives of Internal Medicine, vol. 166, no. 16, 2006, pp. 1768-74.
    Knutson KL, Ryden AM, Mander BA, et al. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med. 2006;166(16):1768-74.
    Knutson, K. L., Ryden, A. M., Mander, B. A., & Van Cauter, E. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Archives of Internal Medicine, 166(16), pp. 1768-74.
    Knutson KL, et al. Role of Sleep Duration and Quality in the Risk and Severity of Type 2 Diabetes Mellitus. Arch Intern Med. 2006 Sep 18;166(16):1768-74. PubMed PMID: 16983057.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. AU - Knutson,Kristen L, AU - Ryden,Armand M, AU - Mander,Bryce A, AU - Van Cauter,Eve, PY - 2006/9/20/pubmed PY - 2006/10/13/medline PY - 2006/9/20/entrez SP - 1768 EP - 74 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 166 IS - 16 N2 - BACKGROUND: Evidence from laboratory and epidemiologic studies suggests that decreased sleep duration or quality may increase diabetes risk. We examined whether short or poor sleep is associated with glycemic control in African Americans with type 2 diabetes mellitus. METHODS: We conducted a cross-sectional study of volunteers with type 2 diabetes interviewed at the University of Chicago Hospitals, Chicago, Ill. The final analysis included 161 participants. Glycemic control was assessed by hemoglobin A1c (HbA1c) level obtained from medical charts. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Perceived sleep debt was calculated as the difference between preferred and actual weekday sleep duration. RESULTS: The mean +/- SD sleep duration was 6.0 +/- 1.6 hours, and 71% of the participants were classified as having poor quality sleep (PSQI score >5). We excluded patients with sleep frequently disrupted by pain (n = 39). In patients without diabetic complications, glycemic control was associated with perceived sleep debt but not PSQI score. The predicted increase in HbA1c level for a perceived sleep debt of 3 hours per night was 1.1% above the median. In patients with at least 1 complication, HbA1c level was associated with PSQI score but not perceived sleep debt. The predicted increase in HbA1c level for a 5-point increase in PSQI was 1.9% above the median. CONCLUSIONS: In our sample, sleep duration and quality were significant predictors of HbA1c, a key marker of glycemic control. Combined with existing evidence linking sleep loss to increased diabetes risk, these data suggest that optimizing sleep duration and quality should be tested as an intervention to improve glucose control in patients with type 2 diabetes. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/16983057/full_citation L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.166.16.1768 DB - PRIME DP - Unbound Medicine ER -