Quantity and Quality of Sleep and Incidence of Type 2 Diabetes

OBJECTIVE To assess the relationship between habitual sleep disturbances and the incidence of type 2 diabetes and to obtain an estimate of the risk. RESEARCH DESIGN AND METHODS We conducted a systematic search of publications using MEDLINE (1955–April 2009), EMBASE, and the Cochrane Library and manual searches without language restrictions. We included studies if they were prospective with follow-up >3 years and had an assessment of sleep disturbances at baseline and incidence of type 2 diabetes. We recorded several characteristics for each study. We extracted quantity and quality of sleep, how they were assessed, and incident cases defined with different validated methods. We extracted relative risks (RRs) and 95% CI and pooled them using random-effects models. We performed sensitivity analysis and assessed heterogeneity and publication bias. RESULTS We included 10 studies (13 independent cohort samples; 107,756 male and female participants, follow-up range 4.2–32 years, and 3,586 incident cases of type 2 diabetes). In pooled analyses, quantity and quality of sleep predicted the risk of development of type 2 diabetes. For short duration of sleep (≤5–6 h/night), the RR was 1.28 (95% CI 1.03–1.60, P = 0.024, heterogeneity P = 0.015); for long duration of sleep (>8–9 h/night), the RR was 1.48 (1.13–1.96, P = 0.005); for difficulty in initiating sleep, the RR was 1.57 (1.25–1.97, P < 0.0001); and for difficulty in maintaining sleep, the RR was 1.84 (1.39–2.43, P < 0.0001). CONCLUSIONS Quantity and quality of sleep consistently and significantly predict the risk of the development of type 2 diabetes. The mechanisms underlying this relation may differ between short and long sleepers.

• Publication year

  2009

• Venue

  Diabetes Care

• Publication date

  2009-11-12

• Fields of study

  Medicine

• Identifiers
  DOI 10.2337/dc09-1124PMID 19910503PMCID 2809295
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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• Sleep duration as a risk factor for incident type 2 diabetes in a multiethnic cohort.

  2009influential reference
• Correlates of Short and Long Sleep Duration: A Cross-Cultural Comparison Between the United Kingdom and the United States: The Whitehall II Study and the Western New York Health Study

  2009cited by this paper
• Effects of gastroesophageal reflux disease on sleep and outcomes.

  2009cited by this paper
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  2008cited by this paper
• 93. Gender-specific associations between disturbed sleep and biomarkers of inflammation, coagulation and insulin resistance

  2008cited by this paper
• 92. Increased stress-induced plasma IL-6 responses in male depressed patients with increased early life stress: Role of catecholamines

  2008cited by this paper
• Gender-specific associations of short sleep duration with prevalent hypertension.

  2008cited by this paper
• Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study.

  2008cited by this paper
• Self-reported symptoms of sleep disturbance and inflammation, coagulation, insulin resistance and psychosocial distress: evidence for gender disparity.

  2008cited by this paper
• Sleep duration and sleep complaints and risk of myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study.

  2007cited by this paper
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  2007cited by this paper
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  2007cited by this paper
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  2007cited by this paper
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  2007cited by this paper
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  2007influential reference
• Sleep duration as a risk factor for the development of type 2 diabetes.

  2006cited by this paper
• Development and validation of MIX: comprehensive free software for meta-analysis of causal research data

  2006cited by this paper
• Sleep measurement in flight crew: comparing actigraphic and subjective estimates to polysomnography.

  2005cited by this paper
• Sleep disturbance as a predictor of type 2 diabetes mellitus in men and women from the general population

  2005influential reference
• Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg.

  2005cited by this paper
• Metabolic and endocrine effects of sleep deprivation.

  2005cited by this paper
• Physiology and Pathophysiology of Sleep Apnea Sleep loss : a novel risk factor for insulin resistance and Type 2 diabetes

  2005cited by this paper
• Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study.

  2005cited by this paper
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  2005cited by this paper
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  2004cited by this paper
• Brief Communication: Sleep Curtailment in Healthy Young Men Is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite

  2004cited by this paper
• A prospective study of sleep duration and mortality risk in women.

  2004cited by this paper
• Leisure time physical activity and the risk of type 2 diabetes in men and women from the general population

  2004cited by this paper
• Incidence of diabetes in middle-aged men is related to sleep disturbances.

  2004cited by this paper
• Sleep disturbance and onset of type 2 diabetes.

  2004cited by this paper
• A prospective study of self-reported sleep duration and incident diabetes in women.

  2003influential reference
• Sleep as restitution: an introduction

  2003cited by this paper
• Quantifying heterogeneity in a meta‐analysis

  2002cited by this paper
• How should meta‐regression analyses be undertaken and interpreted?

  2002cited by this paper
• Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.

  2001cited by this paper
• Empirical assessment of effect of publication bias on meta-analyses

  2000cited by this paper
• Comparison between subjective and actigraphic measurement of sleep and sleep rhythms

  1999cited by this paper
• The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.

  1998cited by this paper
• Historical change in the report of daytime fatigue.

  1996cited by this paper
• The occurrence of sleep-disordered breathing among middle-aged adults.

  1993cited by this paper
• Author Contributions: ST, TY, and

  year unknowncited by this paper

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