title: Interaction of sleep quality and sleep duration on impaired fasting glucose: a population-based cross-sectional survey in China.
abstract: OBJECTIVE
  To explore the interactions of sleep quality and sleep duration and their effects on impaired fasting glucose (IFG) in Chinese adults.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Community-based investigation in Xuzhou, China.
  
  
  METHODS
  15 145 Chinese men and women aged 18-75 years old who fulfilled the inclusion criteria.
  
  
  METHODS
  The Pittsburgh Sleep Quality Index was used to produce sleep quality categories of good, common and poor. Fasting blood glucose levels were assessed for IFG. Sleep duration was measured by average hours of sleep per night, with categories of <6, 6-8 and >8 h. The products of sleep and family history of diabetes, obesity and age were added to the logistic regression model to evaluate the addictive interaction and relative excess risk of interaction (RERI) on IFG. The attributable proportion (AP) of the interaction and the synergy index (S) were applied to evaluate the additive interaction of two factors. Bootstrap measures were used to calculate 95% CI of RERI, AP and S.
  
  
  RESULTS
  The prevalence of IFG was greatest in those with poor sleep quality and short sleep duration (OR 6.37, 95% CI 4.66 to 8.67; p<0.001) compared with those who had good sleep quality and 6-8 h sleep duration, after adjusting for confounders. After adjusting for potential confounders RERI, AP and S values (and their 95% CI) were 1.69 (0.31 to 3.76), 0.42 (0.15 to 0.61) and 2.85 (2.14 to 3.92), respectively, for the interaction between poor sleep quality and short sleep duration, and 0.78 (0.12 to 1.43), 0.61 (0.26 to 0.87) and -65 (-0.94 to -0.27) for the interaction between good sleep quality and long sleep duration.
  
  
  CONCLUSIONS
  The results suggest that there are additive interactions between poor sleep quality and short sleep duration.
authors.affiliation: Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, School of Public Health, Xuzhou Medical University, Xuzhou, China.
authors.forename: Peian
authors.initials: P
authors.lastname: Lou
authors.forename: Peipei
authors.initials: P
authors.lastname: Chen
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Pan
authors.initials: P
authors.lastname: Zhang
authors.forename: Guiqiu
authors.initials: G
authors.lastname: Chang
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
authors.forename: Ting
authors.initials: T
authors.lastname: Li
authors.forename: Cheng
authors.initials: C
authors.lastname: Qiao
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000209:etiology; D005215:Fasting; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011236:Prediabetic State / Q000097:blood / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications*; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose
keywords: Diabetes & Endocrinology; Epidemiology