Sleep Duration as a Risk Factor for Diabetes Incidence in a Large US Sample
Open accessAbstract
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 beta-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.
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Short sleep duration is associated with impaired glucose tolerance and an increased risk of diabetes.
“Short sleep duration is associated with impaired glucose tolerance and an increased risk of diabetes.”
From Sleep Restriction for 1 Week Reduces Insulin Sensitivity in Healthy Men (2010) · cites this paper as [8]
Insufficient sleep duration (quantity) has been associated with an increased risk of obesity, type 2 diabetes, hypertension, cardiovascular disease, metabolic syndrome, and early mortality.
“Insufficient sleep duration (quantity) has been associated with an increased risk of obesity (3–6,51), type 2 diabetes (7–11), hypertension (12), cardiovascular disease (13,14), metabolic syndrome (a combination of cardiovascular and metabolic dysfunction) (15), and early mortality (14,16,17,19–21,52).”
From Sleep Restriction for 1 Week Reduces Insulin Sensitivity in Healthy Men (2010) · cites this paper as [8]
Individuals with obstructive sleep apnea or insomnia are at significantly greater risk for cardiovascular and cerebrovascular diseases and metabolic disorders.
“Population-based studies show that individuals with OSA or insomnia are at significantly greater risk for CVD and cerebrovascular diseases (eg, arrhythmias, atherosclerosis, coronary heart disease [CHD], heart failure, hypertension, and stroke) and metabolic disorders (eg, obesity, type 2 diabetes mellitus, and dyslipidemia).”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [10]
Accumulating evidence points to an association between sleep curtailment and obesity and type 2 diabetes.
“Accumulating evidence has pointed to an association between sleep curtailment and obesity,4,5 type 2 diabetes,6–9 and possibly mortality (see Ref. 10 for a review).”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [9]
In smaller studies, the association between sleep duration and diabetes is more variable.
“In smaller studies, the association between sleep duration and diabetes is more variable.7–9,35”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [9]
Individuals with deficient or disrupted sleep exhibit an increased risk for type 2 diabetes.
“additional epidemiological studies showing that also individuals with deficient or disrupted sleep exhibit an increased risk for type 2 diabetes [141–143].”
From Circadian control of glucose metabolism (2014) · cites this paper as [142]
Some studies observed a U-shaped association between short sleep duration and diabetes.
“Many studies reported increased odds of diabetes associated with short sleep duration (≤5h and/or ≤6h) and some observed a U-shaped association [183–187].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [185]
Many studies reported increased odds of diabetes associated with short sleep duration (≤5h and/or ≤6h).
“Many studies reported increased odds of diabetes associated with short sleep duration (≤5h and/or ≤6h) and some observed a U-shaped association [183–187].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [185]
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- Authors
- Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B., Buijs, R. M., Kreier, F., Pickering, T. G., Rundle, A. G., Zammit, G. K., & Malaspina, D.
- Affiliations
- Columbia University (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Universidad Nacional Autónoma de México (MX)
- Columbia University Irving Medical Center (US)
- New York University (US)
- Corresponding author
- Gangwisch, James E.
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-12
- Volume
- 30
- Issue
- 12
- Pages
- 1667-1673
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2276127
- OpenAlex
- W2118591666
- Cited by
- 573
- References
- 38
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 15 · 2023: 24 · 2022: 25 · 2021: 35 · 2020: 15 · 2019: 29 · 2018: 30 · 2017: 32 · 2016: 40 · 2015: 64 · 2014: 47 · 2013: 50 · 2012: 35
- FWCI
- 31.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R24-HL76857, R24HL076857)
- National Institute of Mental Health (T32MH013043)
- 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 duration, type 2 diabetes, diabetes incidence, short sleep duration, long sleep, obesity, hypertension, insulin resistance, beta-cell function, sleep quality, NHANES I
- MeSH terms
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hypertension, Insulin Resistance, Male, Middle Aged, Obesity, Risk Factors, Sampling Studies, Sleep, Sleep Deprivation, United States, Incidence, Multivariate Analysis, Odds Ratio
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