title: Sleep duration and snoring associate with hypertension and glycaemic control in patients with diabetes.
abstract: OBJECTIVE
  Few studies have analysed the effect of sleep duration and snoring on hypertension and glycaemic control in patients with diabetes. This study aims to investigate the relationship of sleep duration and snoring on prevalent hypertension and glycaemic control in people with diabetes.
  
  
  METHODS
  In the baseline survey of the REACTION study, 56 032 patients with diabetes were categorized into four groups according to self-reported sleep duration: < 6, 6-7.9, 8-8.9 and ≥ 9 h. Snoring frequency was evaluated as 'usually', 'occasionally' or 'never'. Hypertension was assessed by systolic blood pressure, diastolic blood pressure, self-reported previous diagnosis and antihypertensive medications. 'Good' glycaemic control was defined as HbA1c < 53 mmol/mol (7.0%) and 'poor' glycaemic control as HbA1c ≥ 53 mmol/mol (7.0%).
  
  
  RESULTS
  Controlling for potential confounders and intermediates, sleep ≥ 9 h relative to intermediate sleep (6-7.9 h) was significantly associated with prevalent hypertension (OR: 1.25, 95% CI: 1.18-1.32) and poor glycaemic control (OR: 1.11, 95% CI: 1.05-1.18), and a U-shaped association was found between sleep duration and prevalent hypertension (P for quadratic trend = 0.019). Usually snoring was positively associated with prevalent hypertension (OR: 1.30, 95% CI: 1.23-1.37), whereas the association between snoring and poor glycaemic control was only on the borderline of statistical significance.
  
  
  CONCLUSIONS
  Compared with a sleep duration of 6-7.9 h, longer sleep duration was associated with a higher prevalence of hypertension and poor glycaemic control in people with diabetes. Moreover, the relationship between sleep duration and prevalent hypertension was U-shaped. These findings may propose important public health implications for diabetes management.
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: T
authors.initials: T
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Lu
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.affiliation: Chinese People's Liberation Army General Hospital, Beijing, China.
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authors.lastname: Mu
authors.affiliation: Shandong Provincial Hospital affiliated to Shandong University, Jinan, China.
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authors.initials: J
authors.lastname: Zhao
authors.affiliation: Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
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authors.lastname: Liu
authors.affiliation: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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authors.lastname: Chen
authors.affiliation: Affiliated Hospital of Guiyang Medical College, Guiyang, China.
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authors.lastname: Shi
authors.affiliation: The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Q
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authors.affiliation: The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
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authors.lastname: Yang
authors.affiliation: Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
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authors.lastname: Yan
authors.affiliation: The Affiliated Hospital of Luzhou Medical College, Luzhou, China.
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authors.lastname: Wan
authors.affiliation: Karamay Municipal People's Hospital, Xinjiang, China.
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.affiliation: The First Hospital of Jilin University, Changchun, China.
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authors.lastname: Liu
authors.affiliation: The First Hospital of Jilin University, Changchun, China.
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authors.affiliation: The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Luo
authors.affiliation: The First Hospital of Lanzhou University, Lanzhou, China.
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authors.initials: X
authors.lastname: Tang
authors.affiliation: Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
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authors.initials: G
authors.lastname: Chen
authors.affiliation: Jiangxi People's Hospital, Nanchang, China.
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authors.lastname: Huo
authors.affiliation: Dalian Municipal Central Hospital, Dalian, China.
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authors.lastname: Gao
authors.affiliation: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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authors.lastname: Su
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China.
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authors.lastname: Ye
authors.affiliation: The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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authors.lastname: Qin
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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authors.lastname: Deng
authors.affiliation: Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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authors.lastname: Yu
authors.affiliation: The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: F
authors.initials: F
authors.lastname: Shen
authors.affiliation: Qilu Hospital, University of Shandong School of Medicine, Jinan, China.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhao
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: M
authors.initials: M
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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authors.lastname: Sun
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Bi
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: S
authors.initials: S
authors.lastname: Lai
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Z T
authors.initials: ZT
authors.lastname: Bloomgarden
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: D
authors.initials: D
authors.lastname: Li
authors.affiliation: State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012890:Sleep; D012913:Snoring / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human