Insomnia and Diabetes Risk
Research Design and Methods: 1,741 men and women randomly selected from Central Pennsylvania were studied in the sleep laboratory. Insomnia was defined by a complaint of insomnia with duration of ≥ 1 year while poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into three categories: ≥ 6 hours of sleep (top 50% of the sample), 5-6 hours (approximately third quartile of the sample), and ≤ 5 hours (approximately the bottom quartile of the sample). Diabetes was defined either based on a fasting blood glucose > 126 mg/dl or using medication. In the logistic regression model we simultaneously adjusted for age, race, sex, body mass index, smoking, alcohol use, depression, sleep disordered breathing (SDB), and periodic limb movement.
Results: Chronic insomnia but not poor sleep was associated with a higher risk for diabetes. Compared to the normal sleeping and ≥ 6 hour sleep duration group, the highest risk of diabetes was in individuals with insomnia and ≤ 5 hour sleep duration group [OR (95% CI) 2.95 (1.2 – 7.0)], and in insomniacs who slept 5-6 hours [OR (95% CI) 2.07 (0.68 – 6.4)].
Conclusions: Insomnia with short sleep duration is associated with increased odds of diabetes. Objective sleep duration may predict cardiometabolic morbidity of chronic insomnia, whose medical impact has been underestimated.
Alexandros N. Vgontzas, Duanping Liao, Slobodanka Pejovic, Susan Calhoun, Maria Karataraki, and Edward O. Bixler.
Insomnia with Objective Short Sleep Duration is Associated with Type 2 Diabetes: A Population-based Study
Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA 17033.