Prevalence of sleep abnormalities and their association with metabolic syndrome among Asian Indians: Chennai Urban Rural Epidemiology Study (CURES-67).
OBJECTIVE
To estimate the prevalence of sleep abnormalities and their association with glucose intolerance and metabolic syndrome (MS) in the normal-weight urban South Indian population.


METHODS
This population-based, cross-sectional study was carried out in 358 subjects aged 20-76 years randomly selected from the Chennai Urban Rural Epidemiology Study in South India. A validated questionnaire assessing various sleep abnormalities (snoring, daytime sleepiness, lack of refreshing sleep, and number of hours of sleep) was administered. All subjects underwent an oral glucose tolerance test, and anthropometric biochemical measurements were obtained to assess cardiometabolic risk factors including glucose intolerance. Diabetes risk was assessed using a previously validated Indian Diabetes Risk Score (IDRS).


RESULTS
The overall prevalence of snoring and daytime sleepiness was 40% and 59%, respectively. Snorers were more male, older, smokers, and had higher levels of cardiometabolic risk factors. Subjects with daytime sleepiness had higher body mass index (BMI) and abdominal obesity. Both snoring (50.9% vs 30.2%, p<0.001) and daytime sleepiness (68% vs 49.7%, p<0.001) were more prevalent among subjects with impaired glucose metabolism compared to those with normal glucose metabolism. Both sleep measures were associated with higher diabetes risk scores, as assessed by the IDRS (snoring: trend χ2, 11.14, p=0.001; daytime sleepiness: trend χ2, 5.12, p=0.024). Metabolic syndrome was significantly associated with snoring even after adjusting for age, sex, family history of diabetes, physical activity, smoking, and alcohol.


CONCLUSIONS
The prevalence of snoring and daytime sleepiness is high among urban South Indians and these two sleep measures are associated with glucose intolerance, MS, and higher diabetes risk scores.
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization (WHO) Collaborating Centre for Non-Communicable Diseases Prevention and Control, Gopalapuram, Chennai, Tamilnadu, India.
Mahadevan
M
Roopa
Mohan
M
Deepa
Karunakaran
K
Indulekha
Viswanathan
V
Mohan
D000328:Adult; D000368:Aged; D000886:Anthropometry; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D020919:Sleep Disorders, Intrinsic / Q000208:ethnology; D012893:Sleep Wake Disorders / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D012913:Snoring / Q000175:diagnosis / Q000208:ethnology; D011795:Surveys and Questionnaires; D055815:Young Adult
D015415:Biomarkers