title: Association Between Inpatient Sleep Loss and Hyperglycemia of Hospitalization.
abstract: To determine whether inpatient sleep duration and efficiency are associated with a greater risk of hyperglycemia in hospitalized patients with and without diabetes.
  
  
  
  In this retrospective analysis of a prospective cohort study, medical inpatients ≥50 years of age were interviewed, and their charts were reviewed to obtain demographic data and diagnosis. Using World Health Organization criteria, patients were categorized as having normal blood glucose, impaired fasting blood glucose, or hyperglycemia based on morning glucose from the electronic health record. Wrist actigraphy measured sleep. Multivariable ordinal logistic regression models, controlling for subject random effects, tested the association between inpatient sleep duration and proportional odds of hyperglycemia versus impaired fasting blood glucose or impaired fasting blood glucose versus normal blood glucose in hospitalized adults.
  
  
  
  A total of 212 patients (60% female and 74% African American) were enrolled. Roughly one-third (73, 34%) had diabetes. Objective inpatient sleep measures did not differ between patients with or without diabetes. In ordinal logistic regression models, each additional hour of in-hospital sleep was associated with an 11% (odds ratio 0.89 [95% CI 0.80, 0.99]; P = 0.043) lower proportional odds of a higher glucose category the next morning (hyperglycemia vs. elevated and elevated vs. normal). Every 10% increase in sleep efficiency was associated with an 18% lower proportional odds of a higher glucose category (odds ratio 0.82 [95% CI 0.74, 0.89]; P < 0.001).
  
  
  
  Among medical inpatients, both shorter sleep duration and worse sleep efficiency were independently associated with greater proportional odds of hyperglycemia and impaired fasting glucose.
authors.affiliation: Stony Brook University School of Medicine, Stony Brook, NY.
authors.forename: Regina H
authors.initials: RH
authors.lastname: DePietro
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Knutson
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL.
authors.forename: Lisa
authors.initials: L
authors.lastname: Spampinato
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Anderson
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL.
authors.forename: David O
authors.initials: DO
authors.lastname: Meltzer
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL.
authors.forename: Eve
authors.initials: E
authors.lastname: Van Cauter
authors.affiliation: University of Chicago Sleep Metabolism and Health Center, Chicago, IL varora@uchicago.edu.
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D056044:Actigraphy; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood; D011446:Prospective Studies; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood* / Q000150:complications
chemical_list: D001786:Blood Glucose