title: Sleep duration and sleep quality are associated differently with alterations of glucose homeostasis.
abstract: OBJECTIVE
  Studies suggest that inadequate sleep duration and poor sleep quality increase the risk of impaired glucose regulation and diabetes. However, associations with specific markers of glucose homeostasis are less well explained. The objective of this study was to explore possible associations of sleep duration and sleep quality with markers of glucose homeostasis and glucose tolerance status in a healthy population-based study sample.
  
  
  METHODS
  The study comprised 771 participants from the Danish, population-based cross-sectional 'Health2008' study. Sleep duration and sleep quality were measured by self-report. Markers of glucose homeostasis were derived from a 3-point oral glucose tolerance test and included fasting plasma glucose, 2-h plasma glucose, HbA(1c), two measures of insulin sensitivity (the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity), the homeostasis model assessment of β-cell function and glucose tolerance status. Associations of sleep duration and sleep quality with markers of glucose homeostasis and tolerance were analysed by multiple linear and logistic regression.
  
  
  RESULTS
  A 1-h increment in sleep duration was associated with a 0.3 mmol/mol (0.3%) decrement in HbA(1c) and a 25% reduction in the risk of having impaired glucose regulation. Further, a 1-point increment in sleep quality was associated with a 2% increase in both the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity, as well as a 1% decrease in homeostasis model assessment of β-cell function.
  
  
  CONCLUSIONS
  In the present study, shorter sleep duration was mainly associated with later alterations in glucose homeostasis, whereas poorer sleep quality was mainly associated with earlier alterations in glucose homeostasis. Thus, adopting healthy sleep habits may benefit glucose metabolism in healthy populations.
authors.affiliation: Steno Diabetes Center A/S, Gentofte. stinebyberg@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Byberg
authors.forename: A-L S
authors.initials: AL
authors.lastname: Hansen
authors.forename: D L
authors.initials: DL
authors.lastname: Christensen
authors.forename: D
authors.initials: D
authors.lastname: Vistisen
authors.forename: M
authors.initials: M
authors.lastname: Aadahl
authors.forename: A
authors.initials: A
authors.lastname: Linneberg
authors.forename: D R
authors.initials: DR
authors.lastname: Witte
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012890:Sleep / Q000502:physiology*; D013997:Time Factors
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin