Sleep disturbances compared to traditional risk factors for diabetes development: systematic review and meta-analysis
Abstract
Sleep disturbances [short (<6 h) and long (>8 h) sleeping time, insomnia (initiating or maintaining sleep), obstructive sleep apnea (OSA) and abnormal sleep timing] have been associated with increased diabetes risk but the effect size relative to that of traditional risk factors is unknown. We conducted a systematic review and meta-analysis to compare the risk associated with sleep disturbances to traditional risk factors. Studies were identified from Medline and Scopus. Cohort studies measuring the association between sleep disturbances and incident diabetes were eligible. For traditional risk factors (i.e., overweight, family history, and physical inactivity), systematic reviews with or without meta-analysis were included. Thirty-six studies (1,061,555 participants) were included. Pooled relative risks (RRs) of sleep variables were estimated using a random-effect model. Pooled RRs of sleeping ≤5 h, 6 h, and ≥9 h/d were respectively 1.48 (95%CI:1.25,1.76), 1.18 (1.10,1.26) and 1.36 (1.12,1.65). Poor sleep quality, OSA and shift work were associated with diabetes with a pooled RR of 1.40 (1.21,1.63), 2.02 (1.57, 2.61) and 1.40 (1.18,1.66), respectively. The pooled RRs of being overweight, having a family history of diabetes, and being physically inactive were 2.99 (2.42,3.72), 2.33 (1.79,2.79), and 1.20 (1.11,1.32), respectively. In conclusion, the risk of developing diabetes associated with sleep disturbances is comparable to that of traditional risk factors. Sleep disturbances should be considered in clinical guidelines for type 2 diabetes screening.
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Insufficient sleep is a risk factor for the development of type 2 diabetes.
“The detrimental effects of sleep loss on glucose tolerance are now well established, and insufficient sleep is a risk factor for the development of type 2 diabetes (T2D) [1].”
From Exercise mitigates sleep-loss-induced changes in glucose tolerance, mitochondrial function, sarcoplasmic protein synthesis, and diurnal rhythms (2021) · cites this paper as [1]
Sleep loss is comparable with other traditional risk factors for type 2 diabetes, such as physical inactivity.
“In fact, sleep loss is comparable with other more traditional risk factors that are associated with the development of T2D, such as physical inactivity [1].”
From Exercise mitigates sleep-loss-induced changes in glucose tolerance, mitochondrial function, sarcoplasmic protein synthesis, and diurnal rhythms (2021) · cites this paper as [1]
Sleep loss has detrimental effects on glucose tolerance.
“The detrimental effects of sleep loss on glucose tolerance are now well established, and insufficient sleep is a risk factor for the development of type 2 diabetes (T2D) [1].”
From Exercise mitigates sleep-loss-induced changes in glucose tolerance, mitochondrial function, sarcoplasmic protein synthesis, and diurnal rhythms (2021) · cites this paper as [1]
Poor sleep quality is associated with an increased risk of diabetes mellitus.
“Regarding sleep quality, we found that poor sleep quality is associated with an increased risk of diabetes mellitus (56) and gestational diabetes mellitus (53).”
From Sleep Duration/Quality with Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies (2022) · cites this paper as [56]
Sleep disorders are a risk factor for developing type 2 diabetes.
“The associations between sleep problems and diabetes are complex: sleep disorders are a risk factor for developing type 2 diabetes (430,431) and possibly gestational diabetes mellitus (432,433).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [430]
Habitual short sleep duration is associated with a 30-50% increased incidence of diabetes.
“which show that habitual short sleep duration was associated with a 30-50% increased incidence of diabetes.”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [67]
Insufficient sleep duration is associated with diabetes.
“which show that habitual short sleep duration was associated with a 30-50% increased incidence of diabetes.”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [67]
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European guideline for the diagnosis and treatment of insomnia
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Obstructive Sleep Apnea and Diabetes
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Self-citationSleep influences on obesity, insulin resistance, and risk of type 2 diabetes
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Sleep: important considerations for the prevention of cardiovascular disease
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Daytime eating prevents internal circadian misalignment and glucose intolerance in night work
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Sleep interventions and glucose metabolism: systematic review and meta-analysis
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Modelling female physiology from head to Toe: impact of sex hormones, menstrual cycle, and pregnancy
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Association of shift work with incident dementia: a community-based cohort study
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- Authors
- Anothaisintawee, T., Reutrakul, S., Van Cauter, E., & Thakkinstian, A.
- Affiliations
- Mahidol University (TH)
- Corresponding author
- Reutrakul, Sirimon
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 30
- Pages
- 11-24
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2190174002
- Cited by
- 640
- References
- 95
- Citations by year
- 2026: 40 · 2025: 59 · 2024: 63 · 2023: 70 · 2022: 73 · 2021: 81 · 2020: 55 · 2019: 50 · 2018: 61 · 2017: 64 · 2016: 23
- FWCI
- 6.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep disorders, type 2 diabetes, diabetes risk factors, short sleep duration, long sleep, insomnia, obstructive sleep apnea, shift work, poor sleep quality, overweight, family history of diabetes, physical inactivity, diabetes screening
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Risk Factors, Sleep, Sleep Wake Disorders, Sleep Apnea, Obstructive
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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