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Volume :
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30
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Issue :
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12
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Pages :
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1667-1673
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Sleep Duration as a Risk Factor for Diabetes Incidence in a Large US Sample
James E. Gangwisch, PhD1; Steven B. Heymsfield, MD2; Bernadette Boden-Albala, DrPH3; Ruud M. Buijs, PhD4,5; Felix Kreier, PhD4; Thomas G. Pickering, MD, DPhil6; Andrew G. Rundle, DrPH7; Gary K. Zammit, PhD8; Dolores Malaspina, MD9
1Columbia University, College of Physicians and Surgeons, Department of Psychiatry, Division of Medical Genetics, New York, NY; 2Merck Research Laboratories, Rahway, NJ; 3Columbia University, College of Physicians and Surgeons, Department of Neurology and Department of Sociomedical Sciences, New York, NY; 4Netherlands Institute for Brain Research, Amsterdam, The Netherlands; 5Inst. Invest. Biomedicus, UNAM, DF, Mexico; 6Columbia University, College of Physicians and Surgeons, Department of Medicine, Behavioral Cardiovascular Health & Hypertension Program, New York, NY; 7Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY; 8Columbia University, College of Physicians and Surgeons, Department of Psychiatry and Clinilabs Sleep Disorders Institute, New York, NY; 9New York University, School of Medicine, Department of Psychiatry, New York, NY
Study Objectives:
To explore the relationship between sleep duration and diabetes incidence over an 8- to 10-year follow-up period in data from the First National Health and Nutrition Examination Survey (NHANES I). We hypothesized that prolonged short sleep duration is associated with diabetes and that obesity and hypertension act as partial mediators of this relationship. The increased load on the pancreas from insulin resistance induced by chronically short sleep durations can, over time, compromise β-cell function and lead to type 2 diabetes. No plausible mechanism has been identified by which long sleep duration could lead to diabetes.
Design:
Multivariate longitudinal analyses of the NHANES I using logistic regression models.
Setting:
Probability sample (n = 8992) of the noninstitutionalized population of the United States between 1982 and 1992.
Participants:
Subjects between the ages of 32 and 86 years.
Measurements and Results:
Between 1982 and 1992, 4.8% of the sample (n = 430) were determined by physician diagnosis, hospital record, or cause of death to be incident cases of diabetes. Subjects with sleep durations of 5 or fewer hours (odds ratio = 1.47, 95% confidence interval 1.03-2.09) and subjects with sleep durations of 9 or more hours (odds ratio = 1.52, 95% confidence interval 1.06-2.18) were significantly more likely to have incident diabetes over the follow-up period after controlling for covariates.
Conclusions:
Short sleep duration could be a significant risk factor for diabetes. The association between long sleep duration and diabetes incidence is more likely to be due to some unmeasured confounder such as poor sleep quality.
Citation: Gangwisch JE; Heymsfield SB; Boden-Albala B; Buijs RM; Kreier F; Pickering TG; Rundle AG; Zammit GK; Malaspina D. Sleep duration as a risk factor for diabetes incidence in a large US sample. SLEEP 2007;30(12):1667-1673.