title: Insomnia with objective short sleep duration is associated with type 2 diabetes: A population-based study.
abstract: OBJECTIVE
  We examined the joint effects of insomnia and objective short sleep duration, the combination of which is associated with higher morbidity, on diabetes risk.
  
  
  METHODS
  A total of 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 >or=1 year, whereas 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: >or=6 h of sleep (top 50% of the sample); 5-6 h (approximately third quartile of the sample); and <or=5 h (approximately the bottom quartile of the sample). Diabetes was defined either based on a fasting blood glucose >126 mg/dl or use of medication. In the logistic regression model, we simultaneously adjusted for age, race, sex, BMI, smoking, alcohol use, depression, sleep-disordered breathing, and periodic limb movement.
  
  
  RESULTS
  Chronic insomnia but not poor sleep was associated with a higher risk for diabetes. Compared with the normal sleeping and >or=6 h sleep duration group, the highest risk of diabetes was in individuals with insomnia and <or=5 h sleep duration group (odds ratio [95% CI] 2.95 [1.2-7.0]) and in insomniacs who slept 5-6 h (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, the medical impact of which has been underestimated.
authors.affiliation: Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA. avgontzas@psu.edu
authors.forename: Alexandros N
authors.initials: AN
authors.lastname: Vgontzas
authors.forename: Duanping
authors.initials: D
authors.lastname: Liao
authors.forename: Slobodanka
authors.initials: S
authors.lastname: Pejovic
authors.forename: Susan
authors.initials: S
authors.lastname: Calhoun
authors.forename: Maria
authors.initials: M
authors.lastname: Karataraki
authors.forename: Edward O
authors.initials: EO
authors.lastname: Bixler
mesh_terms: D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D044469:Racial Groups; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D013997:Time Factors