title: Population-based cohort study on the increase in the risk for type 2 diabetes mellitus development from nonapnea sleep disorders.
abstract: OBJECTIVE
  The evidence concerning the relationship between nonapnea sleep disorders and the risk for type 2 diabetes mellitus (DM) is scant and elusive. Our study aimed to examine if nonapnea sleep disorders increase the risk for DM using a population-based retrospective cohort study from 1997 to 2010.
  
  
  METHODS
  In the Taiwan's National Health Insurance Research Database (NHIRD), 45,602 patients with nonapnea sleep disorders were identified as the study cohort. The comparison cohort was formed by 91,204 age- and gender-matched controls. Cox proportional hazards regression model was used to estimate the risk for developing DM.
  
  
  RESULTS
  In 45,602 patients with nonapnea sleep disorders, 7241 new cases of DM were reported during the follow-up period. The mean follow-up time was 9.04 (standard deviation [SD], 3.33) and 8.96 (SD, 3.47) for the nonapnea sleep disorders cohort and the comparison cohort, respectively. The incidence rate of DM was higher in the nonapnea sleep disorder cohort than in the comparison cohort (17.6 vs 13.3 per 1000 individuals-years). Overall, patients with nonapnea sleep disorders had a higher risk for DM compared to patients without nonapnea sleep disorders (adjusted hazard ratio [HR], 1.05 [95% confidence interval {CI}, 1.02-1.08]). Men with nonapnea sleep disorders had a higher risk for DM than the men in the comparison group (adjusted HR, 1.08 [95% CI, 1.03-1.14]). Among subjects aged less than 40years, patients with nonapnea sleep disorders had a higher risk for DM than the comparison group (adjusted HR, 1.42 [95% CI, 1.27-1.59]). Compared with the comparison cohort, patients with sleep disturbance had an 11% higher risk for DM (adjusted HR, 1.11 [95% CI, 1.07-1.16]).
  
  
  CONCLUSIONS
  Compared to patients without nonapnea sleep disorders, patients with nonapnea sleep disorders had a higher risk for developing DM, especially among those who were less than 40years of age and who had sleep disturbances.
authors.affiliation: Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yun-Ju
authors.initials: YJ
authors.lastname: Lai
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Shih-Tan
authors.initials: ST
authors.lastname: Lee
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
keywords: Cohort study; Diabetes mellitus; Diabetic risk; Insomnia; Nonapnea sleep disorders; Sleep disturbance