Association between sleep duration and diabetes in black and white adults
Open accessAbstract
OBJECTIVE: To examine racial differences in sleep duration and its relationship with diabetes. RESEARCH DESIGN AND METHODS: We used data from a nationally representative sample of U.S. adults (n = 130,943) participating in the National Health Interview Survey from 2004 to 2011. Usual sleep duration was self-reported and categorized as <7 h (short), 7 h (optimal), and >7 h (long). Diabetes status was based on self-reported diagnosis from a health professional. RESULTS: Participants' mean age was 50.6 years, 49% were men, and 13% were black. Compared with whites, blacks were more likely to report short sleep (37 vs. 28%) and less likely to get 7 h of sleep (24 vs. 33%). Diabetes (9,643 cases [9%] in whites and 3,612 cases [15%] in blacks) had a U-shaped distribution with sleep in whites (10, 7, and 9%, for short, optimal, and long sleep, respectively) and blacks (16, 13, and 15%). Suboptimal sleep duration was more strongly associated with diabetes in whites than in blacks among short (prevalence ratio 1.49 [95% CI 1.40-1.58] vs. 1.21 [1.09-1.34]) and long (1.32 [1.25-1.40] vs. 1.11 [1.00-1.23]) sleepers on the relative scale. Adjustment for socioeconomic status (SES) attenuated the short sleep-diabetes association in blacks (1.15 [1.02-1.29]), and the racial/ethnic difference in the short sleep-diabetes association became nonsignificant after SES adjustments. CONCLUSIONS: Suboptimal sleep duration was positively associated with diabetes in blacks and whites, although diabetes prevalence was higher at any level of sleep in blacks. Socioeconomic factors appear to partly explain the association for short sleep in blacks as well as disparity between racial groups.
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Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (22%, 2/9).
“Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (SMBG) (22%, 2/9) [10,20,23], [25,26,30,31,34,37].”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [26]
The Research Design and Methods sections describe a survey analysis of sleep duration and diabetes; physical activity is measured as a participant characteristic. Searches for technology-assisted studies, medication adherence, dietary behaviors, SMBG, and the stated study counts found no passage addressing the claimed breakdown. The supplied passages have no page numbers. (LLM, conf=0.76)
Experimental — accuracy not yet measuredStudies such as [20,25,26,31] implemented these technologies to enhance patient self-monitoring, treatment adherence, and real-time behavioral tracking.
“Studies such as [20,25,26,31] implemented these technologies to enhance patient self-monitoring, treatment adherence, and real-time behavioral tracking.”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [26]
The National Health Interview Survey section describes a cross-sectional survey using computer-assisted interviews, not a technology implemented to improve patient care. The Measures section describes self-reported sleep, diabetes, and health behaviors; searches for self-monitoring, treatment adherence, and real-time behavioral tracking found no passage addressing those uses. (LLM, conf=0.78)
Experimental — accuracy not yet measuredTechnology-assisted methods showed promise in improving behavioral tracking and real-time feedback.
“while technology-assisted methods showed promise in improving behavioral tracking and real-time feedback [26,31]”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [26]
The National Health Interview Survey section describes computer-assisted interviews, and the Measures section describes self-reported sleep and health behaviors. Neither section reports that technology-assisted methods improved behavioral tracking or provided real-time feedback; searches for those concepts found no supporting passage. Page numbers were not available in our copy. (LLM, conf=0.76)
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References 36 · Cited by 101
- Authors
- Jackson, C. L., Redline, S., Kawachi, I., & Hu, F. B.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Jackson, Chandra L.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2013-10-15
- Volume
- 36
- Issue
- 11
- Pages
- 3557-3565
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3816913
- OpenAlex
- W2103624550
- Cited by
- 101
- References
- 36
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 11 · 2022: 4 · 2021: 13 · 2020: 4 · 2019: 6 · 2018: 12 · 2017: 3 · 2016: 14 · 2015: 11 · 2014: 5
- FWCI
- 13.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Cancer Institute (U54CA155626)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007703)
- 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, diabetes mellitus, racial disparities, Black people, socioeconomic status, short sleep duration, long sleep, U-shaped relationship, diabetes prevalence, health disparities
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Sleep, Socioeconomic Factors, Prevalence, Black People, White People, Self Report
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