Insomnia With Objective Short Sleep Duration Is Associated With Type 2 Diabetes
Open accessAbstract
OBJECTIVE We examined the joint effects of insomnia and objective short sleep duration, the combination of which is associated with higher morbidity, on diabetes risk. RESEARCH DESIGN AND METHODS A total of 1,741 men and women randomly selected from Central Pennsylvania were studied in the sleep laboratory. Insomnia was defined by a complaint of insomnia with duration of ≥1 year, whereas poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into three categories: ≥6 h of sleep (top 50% of the sample); 5–6 h (approximately third quartile of the sample); and ≤5 h (approximately the bottom quartile of the sample). Diabetes was defined either based on a fasting blood glucose >126 mg/dl or use of medication. In the logistic regression model, we simultaneously adjusted for age, race, sex, BMI, smoking, alcohol use, depression, sleep-disordered breathing, and periodic limb movement. RESULTS Chronic insomnia but not poor sleep was associated with a higher risk for diabetes. Compared with the normal sleeping and ≥6 h sleep duration group, the highest risk of diabetes was in individuals with insomnia and ≤5 h sleep duration group (odds ratio [95% CI] 2.95 [1.2–7.0]) and in insomniacs who slept 5–6 h (2.07 [0.68–6.4]). CONCLUSIONS Insomnia with short sleep duration is associated with increased odds of diabetes. Objective sleep duration may predict cardiometabolic morbidity of chronic insomnia, the medical impact of which has been underestimated.
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Cites
Prevalence of Sleep-disordered Breathing in Women
BIXLER, E. O., VGONTZAS, A. N., LIN, H.-M., TEN HAVE, T., REIN, J., VELA-BUENO, A., & KALES, A. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.3.9911064 · Cited by 1,598 · see citing works
Self-citationEffects of Age on Sleep Apnea in Men: I. Prevalence and Severity
Bixler, E. O., Vgontzas, A. N., Have, T. T., Tyson, K. L., & Kales, A. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.1.9706079 · Cited by 1,239 · see citing works
Self-citationSleep loss: a novel risk factor for insulin resistance and type 2 diabetes
Spiegel, K., Knutson, K., Leproult, R., Tasali, E., & Cauter, E. V. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00660.2005 · Cited by 1,175 · see citing works
Punjabi, N. M. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh261 · Cited by 1,107 · see citing works
Adverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines
Vgontzas, A. N., Zoumakis, E., Bixler, E. O., Lin, H.-M., Follett, H., Kales, A., & Chrousos, G. P. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031562 · Cited by 1,050 · see citing works
Self-citationAssociation of sleep time with diabetes mellitus and impaired glucose tolerance
Gottlieb, D. J., Punjabi, N. M., Newman, A. B., Resnick, H. E., Redline, S., Baldwin, C. M., & Nieto, F. J. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.8.863 · Cited by 927 · see citing works
Vgontzas, A. N., Bixler, E. O., Lin, H.-M., Prolo, P., Mastorakos, G., Vela-Bueno, A., Kales, A., & Chrousos, G. P. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.8.7778 · Cited by 884 · see citing works
Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension
Vgontzas, A. N., Liao, D., Bixler, E. O., Chrousos, G. P., & Vela-Bueno, A. (2009) · Sleep · doi:10.1093/sleep/32.4.491 · Cited by 748 · see citing works
Self-citationObjectively Measured Sleep Characteristics among Early-Middle-Aged Adults
Lauderdale, D. S., Knutson, K. L., Yan, L. L., Rathouz, P. J., Hulley, S. B., Sidney, S., & Liu, K. (2006) · American Journal of Epidemiology · doi:10.1093/aje/kwj199 · Cited by 581 · see citing works
24-Hour Metabolic Rate in Insomniacs and Matched Normal Sleepers
Bonnet, M. H., & Arand, D. L. (1995) · Sleep · doi:10.1093/sleep/18.7.581 · Cited by 557 · see citing works
Heart Rate Variability in Insomniacs and Matched Normal Sleepers
Bonnet, M. H., & Arand, D. L. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199809000-00017 · Cited by 451 · see citing works
Chronic insomnia and activity of the stress system
Vgontzas, A. N., Tsigos, C., Bixler, E. O., Stratakis, C. A., Zachman, K., Kales, A., Vela-Bueno, A., & Chrousos, G. P. (1998) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(97)00302-4 · Cited by 401 · see citing works
Self-citationHigh Incidence of Diabetes in Men With Sleep Complaints or Short Sleep Duration
Mallon, L., Broman, J.-E., & Hetta, J. (2005) · Diabetes Care · doi:10.2337/diacare.28.11.2762 · Cited by 391 · see citing works
Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances
Nilsson, P. M., Rööst, M., Engström, G., Hedblad, B., & Berglund, G. (2004) · Diabetes Care · doi:10.2337/diacare.27.10.2464 · Cited by 322 · see citing works
Relationship between reported and measured sleep times: the sleep heart health study (SHHS)
Silva, G. E., Goodwin, J. L., Sherrill, D. L., Arnold, J. L., Bootzin, R. R., Smith, T., Walsleben, J. A., Baldwin, C. M., & Quan, S. F. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26974 · Cited by 295 · see citing works
Chronic Insomnia and the Stress System
Basta, M., Chrousos, G. P., Vela‐Bueno, A., & Vgontzas, A. N. (2007) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2007.04.002 · Cited by 294 · see citing works
Self-citationSleep Disturbance and Onset of Type 2 Diabetes
Kawakami, N., Takatsuka, N., & Shimizu, H. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.282 · Cited by 247 · see citing works
Study, T. M. A. C., Meisinger, C., Heier, M., & Loewel, H. (2005) · Diabetologia · doi:10.1007/s00125-004-1634-x · Cited by 234 · see citing works
Do Insomnia Complaints Cause Hypertension or Cardiovascular Disease?
Phillips, B. A., & Mannino, D. M. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26913 · Cited by 227 · see citing works
Sleep Disturbances in Midlife Unrelated to 32-Year Diabetes Incidence
Björkelund, C., Bondyr-Carlsson, D., Lapidus, L., Lissner, L., Månsson, J., Skoog, I., & Bengtsson, C. (2005) · Diabetes Care · doi:10.2337/diacare.28.11.2739 · Cited by 158 · see citing works
Rodenbeck, A., Cohrs, S., Jordan, W., Huether, G., R�ther, E., & Hajak, G. (2003) · Psychopharmacology · doi:10.1007/s00213-003-1565-0 · Cited by 103 · see citing works
(2005) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26373 · Cited by 90 · see citing works
Insomnia Did Not Predict Incident Hypertension in Older Adults in the Cardiovascular Health Study
Phillips, B. A., Bůžková, P., & Enright, P. (2009) · SLEEP · doi:10.5665/sleep/32.1.65 · Cited by 82 · see citing works
Heart rate changes in chronic insomnia
Stepanski, E. J., Glinn, M. A., Zorick, F. J., Roehrs, T., & Roth, T. G. (1994) · Stress Medicine · doi:10.1002/smi.2460100409 · Cited by 82 · see citing works
Sleep Apnea and Metabolic Dysfunction: Cause or Co-Relation?
Aurora, R. N., & Punjabi, N. M. (2007) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2007.03.006 · Cited by 26 · see citing works
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Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M. W., & Cunnington, D. (2015) · Annals of Internal Medicine · doi:10.7326/m14-2841 · Cited by 1,053 · see citing works
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Espie, C. A., Kyle, S. D., Hames, P., Gardani, M., Fleming, L., & Cape, J. (2014) · BMJ Open · doi:10.1136/bmjopen-2013-004183 · Cited by 517 · see citing works
Espie, C. A., Emsley, R., Kyle, S. D., Gordon, C., Drake, C. L., Siriwardena, A. N., Cape, J., Ong, J. C., Sheaves, B., Foster, R., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.2745 · Cited by 466 · see citing works
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Jackson, C. L., Redline, S., & Emmons, K. M. (2015) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031914-122838 · Cited by 388 · see citing works
Gehrman, P., Seelig, A. D., Jacobson, I. G., Boyko, E. J., Hooper, T. I., Gackstetter, G. D., Ulmer, C. S., Smith, T. C., & Millennium Cohort Study Team (2013) · Sleep · doi:10.5665/sleep.2798 · Cited by 339 · see citing works
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Hsieh, S. D., Muto, T., Murase, T., Tsuji, H., & Arase, Y. (2011) · Internal Medicine · doi:10.2169/internalmedicine.50.5844 · Cited by 99 · see citing works
Léger, D., Roscoat, E. D., Bayon, V., Guignard, R., Pâquereau, J., & Beck, F. (2011) · Sleep Medicine · doi:10.1016/j.sleep.2010.12.012 · Cited by 95 · see citing works
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Carroll, J. E., Esquivel, S., Goldberg, A., Seeman, T. E., Effros, R. B., Dock, J., Olmstead, R., Breen, E. C., & Irwin, M. R. (2016) · Sleep · doi:10.5665/sleep.5526 · Cited by 85 · see citing works
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- Authors
- Vgontzas, A. N., Liao, D., Pejovic, S., Calhoun, S., Karataraki, M., & Bixler, E. O.
- Affiliations
- Pennsylvania State University (US)
- Corresponding author
- Vgontzas, Alexandros N.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-07-29
- Volume
- 32
- Issue
- 11
- Pages
- 1980-1985
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2768214
- OpenAlex
- W1984151168
- Cited by
- 551
- References
- 25
- Citations by year
- 2026: 26 · 2025: 32 · 2024: 30 · 2023: 28 · 2022: 30 · 2021: 26 · 2020: 39 · 2019: 32 · 2018: 38 · 2017: 35 · 2016: 44 · 2015: 38 · 2014: 35 · 2013: 33 · 2012: 27
- FWCI
- 35.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL040916, R01HL064415, R01HL 40916, R01 HL64415, R01 HL51931, R01HL051931)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- chronic insomnia, short sleep duration, type 2 diabetes, diabetes risk, polysomnography, sleep duration, poor sleep quality
- MeSH terms
- Depression, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Sleep Initiation and Maintenance Disorders, Interviews as Topic, Male, Obesity, Pennsylvania, Risk Factors, Sleep Wake Disorders, Time Factors, Multivariate Analysis, Odds Ratio, Racial Groups
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