Sleep duration as a risk factor for diabetes incidence in a large U.S. sample.
OBJECTIVE
To explore the relationship between sleep duration and diabetes incidence over an 8- to 10-year follow-up period in data from the First National Health and Nutrition Examination Survey (NHANES I). We hypothesized that prolonged short sleep duration is associated with diabetes and that obesity and hypertension act as partial mediators of this relationship. The increased load on the pancreas from insulin resistance induced by chronically short sleep durations can, over time, compromise beta-cell function and lead to type 2 diabetes. No plausible mechanism has been identified by which long sleep duration could lead to diabetes.


METHODS
Multivariate longitudinal analyses of the NHANES I using logistic regression models.


METHODS
Probability sample (n=8992) of the noninstitutionalized population of the United States between 1982 and 1992.


METHODS
Subjects between the ages of 32 and 86 years.


RESULTS
Between 1982 and 1992, 4.8% of the sample (n=430) were determined by physician diagnosis, hospital record, or cause of death to be incident cases of diabetes. Subjects with sleep durations of 5 or fewer hours (odds ratio = 1.47, 95% confidence interval 1.03-2.09) and subjects with sleep durations of 9 or more hours (odds ratio = 1.52, 95% confidence interval 1.06-2.18) were significantly more likely to have incident diabetes over the follow-up period after controlling for covariates.


CONCLUSIONS
Short sleep duration could be a significant risk factor for diabetes. The association between long sleep duration and diabetes incidence is more likely to be due to some unmeasured confounder such as poor sleep quality.
Gangwisch
James E
JE
Columbia University, College of Physicians and Surgeons, Department of Psychiatry, Division of Medical Genetics, 1051 Riverside Drive, Mailbox #2, New York, NY 10032, USA. jeg64@columbia.edu
Heymsfield
Steven B
SB
Boden-Albala
Bernadette
B
Buijs
Ruud M
RM
Kreier
Felix
F
Pickering
Thomas G
TG
Rundle
Andrew G
AG
Zammit
Gary K
GK
Malaspina
Dolores
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D012494:Sampling Studies; D012890:Sleep; D012892:Sleep Deprivation / Q000453:epidemiology; D014481:United States