title: Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes.
abstract: OBJECTIVE
  To examine the association between sleep duration and cardiometabolic risk factors among individuals with recently diagnosed type 2 diabetes (n = 391).
  
  
  METHODS
  Sleep duration was derived using a combination of questionnaire and objective heart rate and movement sensing in the UK ADDITION-Plus study (2002-2007). Adjusted means were estimated for individual cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) by five categories of sleep duration.
  
  
  RESULTS
  We observed a J-shaped association between sleep duration and CCMR - individuals sleeping 7 to <8 h had a significantly better CCMR profile than those sleeping ≥9 h. Independent of physical activity and sedentary time, individuals sleeping 7 to <8 h had lower triacylglycerol (0.62 mmol/l (0.29, 1.06)) and higher high-density lipoprotein (HDL)-cholesterol levels (0.23 mmol/l (0.16, 0.30)) compared with those sleeping ≥9 h, and a lower waist circumference (7.87 cm (6.06, 9.68)) and body mass index (BMI) (3.47 kg/m(2) (2.69, 4.25)) than those sleeping <6 h. Although sleeping 7 to <8 h was associated with lower levels of systolic and diastolic blood pressure, HbA1c, total cholesterol, and low-density lipoprotein (LDL)-cholesterol, these associations were not statistically significant.
  
  
  CONCLUSIONS
  Sleep duration has a J-shaped association with CCMR in individuals with diabetes, independent of potential confounding. Health promotion interventions might highlight the importance of adequate sleep in this high-risk population.
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. Electronic address: andrew.cooper@mrc-epid.cam.ac.uk.
authors.forename: Andrew J M
authors.initials: AJ
authors.lastname: Cooper
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Westgate
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
authors.forename: Søren
authors.initials: S
authors.lastname: Brage
authors.affiliation: Department of Primary Care and Public Health Science, King's College London, London, SE1 3QD, UK.
authors.forename: A Toby
authors.initials: AT
authors.lastname: Prevost
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK; The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Simmons
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057185:Sedentary Behavior; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D014280:Triglycerides; D002784:Cholesterol
keywords: BMI; Cardiovascular risk; Lipids; Sleep duration; Type 2 diabetes; Waist circumference