Sleep Disturbances in Midlife Unrelated to 32-Year Diabetes Incidence
Open accessAbstract
OBJECTIVE—To study the relation between diabetes incidence and sleep problems in a population-based sample of women followed for 32 years. RESEARCH DESIGN AND METHODS—The researchers conducted a prospective population study initiated in 1968–1969, with follow-ups in 1974–1975, 1980–1981, 1992–1993, and 2000–2001 in Gothenburg, Sweden. A total of 1,462 women born in 1908, 1914, 1918, 1922, and 1930, representative of women of the same ages in the general population, initially participated (90% participation rate). Reported sleep duration, sleep problems, and use of sleeping medication were related to incident diabetes from 1968 to 2000. Associations between sleep problems and diabetes were corrected for waist-to-hip ratio (WHR), BMI, subscapular skinfold, fasting blood glucose and serum lipid concentrations, blood pressure, heart rate, smoking, physical activity, education, and socioeconomic status. Additionally, associations between BMI, WHR, and sleep problems were examined. RESULTS—Over 32 years, 126 women (8.7%) developed diabetes. Associations between diabetes and initial sleep problems were tested in a Cox regression analysis, taking into consideration factors associated (P < 0.1) with diabetes. Sleep problems in 1968 did not increase risk of developing diabetes during the following 32 years. Obesity, particularly centralized, was associated with sleep problems. CONCLUSIONS—No association between sleep problems and developing diabetes was seen in this 32-year follow-up of middle-aged women. Obesity, on the other hand, known to cause increased risk of diabetes, was associated with current sleep problems.
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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 [7]
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 [7]
One study did not find a significant association between sleep and incident diabetes.
“Note that one study did not find a significant association between sleep and incident diabetes [194]”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [194]
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Sleep problems and major weight gain: a follow-up study
Lyytikäinen, P., Lallukka, T. M., Lahelma, E. T., & Rahkonen, O. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.113 · Cited by 72 · see citing works
O'Keeffe, M., & St-Onge, M. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.142 · Cited by 74 · see citing works
Sakamoto, R., Yamakawa, T., Takahashi, K., Suzuki, J., Shinoda, M., Sakamaki, K., Danno, H., Tsuchiya, H., Waseda, M., Takano, T., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0191771 · Cited by 71 · see citing works
Sleep and Glucose Intolerance/Diabetes Mellitus
Ip, M., & Mokhlesi, B. (2007) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2006.12.002 · Cited by 67 · see citing works
“Similarly, no association between sleep duration at baseline and diabetic risk was shown in women in a 32-year follow-up [41,42].”
BackgroundRisk of type 2 diabetes in patients with insomnia: A population‐based historical cohort study
Lin, C., Chien, W., Chung, C., & Wu, F. (2017) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2930 · Cited by 68 · see citing works
Bo, S., Ciccone, G., Durazzo, M., Ghinamo, L., Villois, P., Canil, S., Gambino, R., Cassader, M., Gentile, L., & Cavallo-Perin, P. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.5 · Cited by 61 · see citing works
Ding, C., Lim, L., Li, X., & Kong, A. P. S. (2018) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes.2018.27.1.4 · Cited by 75 · see citing works
Do Sleep Disorders and Associated Treatments Impact Glucose Metabolism?
Punjabi, N. M. (2009) · Drugs · doi:10.2165/11531150-000000000-00000 · Cited by 59 · see citing works
Osonoi, Y., Mita, T., Osonoi, T., Saito, M., Tamasawa, A., Nakayama, S., Someya, Y., Ishida, H., Kanazawa, A., Gosho, M., et al. (2015) · BMC Endocrine Disorders · doi:10.1186/s12902-015-0026-1 · Cited by 60 · see citing works
“UAE (mg/g creatinine) 10 [6,21] 10 [6,25] 16 [7,40] 2.”
Does lack of sleep cause diabetes?
Touma, C., & Pannain, S. (2011) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.78a.10165 · Cited by 52 · see citing works
Mehlig, K., Skoog, I. G., Wærn, M., Jonasson, J. M., Lapidus, L., Björkelund, C., Östling, S., & Lissner, L. (2014) · Neuroepidemiology · doi:10.1159/000362201 · Cited by 52 · see citing works
Self-citationLiu, J., Hay, J., & Faught, B. E. (2013) · International Journal of Endocrinology · doi:10.1155/2013/234129 · Cited by 49 · see citing works
“For instance, a cohort of women from Gothenburg, Sweden, were followed for 32 years, and no significant associations or trends were observed between incidence of diabetes and any of the available sleep indicators; however, obesity status, using either BMI orwaist circumference, was highly associatedwith sleep problems…”
BackgroundSleep & the metabolic syndrome.
Lam, J., & Ip, M. (2010) · PubMed · Cited by 52 · see citing works
Sleep Disorders, Glucose Regulation, and Type 2 Diabetes
Taub, L. M., & Redeker, N. S. (2007) · Biological Research For Nursing · doi:10.1177/1099800407311016 · Cited by 43 · see citing works
“…examined the relationships between sleep and the development of diabetes in male and female participants followed from 5.5 months to 32 years (Ayas et al., 2003; Bjorkelund et al., 2005; Kawakami et al., 2004; Mallon et al., 2005; Meisinger et al., 2005; Nilsson et al., 2004; Yaggi et al., 2006).”
BackgroundInfluentialAssociation between sleeping difficulty and type 2 diabetes in women
Li, Y., Gao, X., Winkelman, J. W., Feliciano, E. M. C., Jackson, C. L., Walters, A. S., Schernhammer, E. S., Redline, S. S., & Hu, F. B. (2016) · Diabetologia · doi:10.1007/s00125-015-3860-9 · Cited by 45 · see citing works
“So far, six studies have addressed the impact of selfreported difficulty falling or staying asleep and the risk of type 2 diabetes [9–12, 24–26].”
Sleep Duration and Obesity in Adults: What Are the Connections?
Theorell‐Haglöw, J., & Lindberg, E. (2016) · Current Obesity Reports · doi:10.1007/s13679-016-0225-8 · Cited by 43 · see citing works
Lu, H., Yang, Q., Tian, F., Lyu, Y., He, H., Xin, X., & Zheng, X. (2021) · Journal of Diabetes Research · doi:10.1155/2021/8861038 · Cited by 42 · see citing works
Association between sleep duration and diabetes mellitus: Isfahan Healthy Heart Program
Najafian, J., Mohamadifard, N., Siadat, Z., Sadri, G., & Rahmati, M. (2013) · Nigerian Journal of Clinical Practice · doi:10.4103/1119-3077.106756 · Cited by 40 · see citing works
“In a number of cohort studies,[7-12] it has been shown that sleep disturbances including either an increased or decreased length of nocturnal sleep may increase an incidence of type-2 diabetes, with a higher rate in men than in women.”
BackgroundCorrelation between Sleep Duration and Risk of Stroke
Patyar, S., & Patyar, R. R. (2015) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2014.12.038 · Cited by 40 · see citing works
Sleep Apnea–Hypopnea Syndrome and Type 2 Diabetes. A Reciprocal Relationship?
Martínez-Cerón, E., Mateos, R. C., & Rio, F. G. (2015) · Archivos de Bronconeumología · doi:10.1016/j.arbr.2014.12.007 · Cited by 41 · see citing works
“Therefore, the increase in 111,112”
Síndrome de apneas-hipopneas del sueño y diabetes tipo 2. ¿Una relación de ida y vuelta?
Martínez-Cerón, E., Mateos, R. C., & Rio, F. G. (2014) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2014.06.017 · Cited by 39 · see citing works
Iwasaki, M., Hirose, T., Mita, T., Sato, F., Ito, C., Yamamoto, R., Someya, Y., Yoshihara, T., Tamura, Y., Kanazawa, A., et al. (2013) · Journal of Diabetes Investigation · doi:10.1111/jdi.12047 · Cited by 39 · see citing works
Endocrine Physiology in Relation to Sleep and Sleep Disturbances
Cauter, E. V., & Tasali, E. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4160-6645-3.00026-8 · Cited by 38 · see citing works
Gao, X., Sun, H., Zhang, Y., Liu, L., Wang, J., & Wang, T. (2020) · Frontiers in Genetics · doi:10.3389/fgene.2020.607865 · Cited by 36 · see citing works
“Despite previous observational evidence of the relationship between sleep and T2DM, there are also inconsistent results (Björkelund et al., 2005; Lai et al., 2013).”
ResultShadyab, A. H., Kritz‐Silverstein, D. C., Laughlin, G. A., Wooten, W. J., Barrett-Connor, E. L., & Araneta, M. R. G. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.11.010 · Cited by 35 · see citing works
Disorders of Glucose Metabolism in Sleep-disordered Breathing
Lui, M. M., & Ip, M. (2010) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2010.02.001 · Cited by 34 · see citing works
Sleep Optimization and Diabetes Control: A Review of the Literature
Arora, T., & Taheri, S. (2015) · Diabetes Therapy · doi:10.1007/s13300-015-0141-z · Cited by 34 · see citing works
“Other prospective discrepancies exist from a powerful 32-year follow-up study [27] finding no association between sleep and incident diabetes.”
BackgroundLin, C., Tsai, Y., & Yeh, M. C. (2016) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2016.01.013 · Cited by 31 · see citing works
Xiao, Q., Gu, F., Caporaso, N. E., & Matthews, C. E. (2016) · BMC Obesity · doi:10.1186/s40608-016-0128-y · Cited by 31 · see citing works
“Although no other studies examined sleep in relation to android/gynoid fat ratio, earlier reports showed an inverse association between sleep duration and waist-to-hip ratio [30, 39], a substitute measure of android/gynoid fat ratio.”
ResultTom, S. E., & Berenson, A. B. (2013) · Women s Health Issues · doi:10.1016/j.whi.2013.06.002 · Cited by 30 · see citing works
“Previous studies have shown that short sleep duration, an indicator of poor sleep quality (Vgontzas et al., 2008), is related cross-sectionally to obesity (Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005), higher body mass index (BMI; Bjorkelund et al., 2005; s Health.”
BackgroundAssociation of Sleep Duration and Overweight/Obesity among Children in China
Fan, J., Ding, C., Gong, W., Yuan, F., Zhang, Y., Feng, G., Song, C., & Liu, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17061962 · Cited by 30 · see citing works
Lallukka, T. M., Haario, P., Lahelma, E. T., & Rahkonen, O. (2012) · Sleep Medicine · doi:10.1016/j.sleep.2012.06.020 · Cited by 30 · see citing works
Zhang, Y., Lin, Y., Zhang, J., Li, L., Liu, X., Wang, T., & Gao, Z. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1687-6 · Cited by 27 · see citing works
“searchers observed no significant association between sleep disorders and diabetes [28].”
BackgroundBehavioral Medicine and Sleep: Concepts, Measures, and Methods
Hall, M. H. (2010) · Springer eBooks · doi:10.1007/978-0-387-09488-5_49 · Cited by 24 · see citing works
Sleep quality and risk of diabetes and coronary artery disease among young men
Twig, G., Shina, A., Afek, A. B., Derazne, E., Tzur, D., Cukierman‐Yaffe, T., Shechter-Amir, D., Gerstein, H. C., & Tirosh, A. (2015) · Acta Diabetologica · doi:10.1007/s00592-015-0779-z · Cited by 25 · see citing works
“Studies of younger adults assessing the relationship between sleep disturbance and cardio-metabolic risk are scarce, and results are conflicting [4–6], emphasizing the need for additional, large, prospective studies in this population.”
ResultSleep problems in adolescence and overweight/obesity in young adults: is there a causal link?
Fatima, Y., Doi, S. A. R., & Mamun, A. A. (2018) · Sleep Health · doi:10.1016/j.sleh.2018.01.002 · Cited by 21 · see citing works
Duval, S., Vazquez, G., Baker, W. L., Jacobs, D. R., & for the CODA Study Group (2007) · Obesity Reviews · doi:10.1111/j.1467-789x.2006.00263.x · Cited by 22 · see citing works
Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women
Bergdahl, I. A., Ahlqwist, M., Barregård, L., Björkelund, C., Blomstrand, A., Skerfving, S., Sundh, V., Wennberg, M., & Lissner, L. (2012) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-012-0746-8 · Cited by 22 · see citing works
“Diabetes was also accepted as diagnosis if recorded in the death certiWcate (Björkelund et al. 2005).”
BackgroundSelf-citationEffects of Sleep Deficiency on Hormones, Cytokines, and Metabolism
Buxton, O. M., Broussard, J. L., Zahl, A. K., & Hall, M. H. (2013) · Springer eBooks · doi:10.1007/978-1-4614-9527-7_2 · Cited by 21 · see citing works
McWhorter, K. L., Park, Y., Gaston, S. A., Fang, K., Sandler, D. P., & Jackson, C. L. (2019) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000652 · Cited by 21 · see citing works
Zheng, Y., Wang, A., Pan, C., Lu, J., Dou, J., Lü, Z., Ba, J., Wang, B., & Mu, Y. (2014) · Journal of Diabetes · doi:10.1111/1753-0407.12186 · Cited by 19 · see citing works
“The two groups were then further subdivided into three groups according to sleep duration: <6, 6–9, and >9 h.(6,10)”
BackgroundLow fasting serum insulin and dementia in nondiabetic women followed for 34 years
Mehlig, K., Lapidus, L., Thelle, D. S., Wærn, M., Zetterberg, H., Björkelund, C., Skoog, I. G., & Lissner, L. (2018) · Neurology · doi:10.1212/wnl.0000000000005911 · Cited by 19 · see citing works
“Follow-up examinations were carried out in 1974, 1980, 1992, and 2000,with participation rates among those still alive decreasing from 91% in 1968 to 71% in 2000.(16,17)”
BackgroundSelf-citationCasas, R. S., Gabriel, K. P., Kriska, A. M., Kuller, L. H., & Conroy, M. B. (2011) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e318230f531 · Cited by 19 · see citing works
“tudinal study of postmenopausal women over 32 years, sleep disturbance was associated with obesity at midlife but did not affect future diabetes incidence.(46) Weight gain did not differ over time between women with and women without sleep disturbance.”
BackgroundSleep duration and anthropometric indices in an Iranian population: the Fasa PERSIAN cohort study
Yazdanpanah, M. H., Farjam, M., Naghizadeh, M. M., Jedi, F., Mohebi, K., & Homayounfar, R. (2021) · Scientific Reports · doi:10.1038/s41598-021-95796-9 · Cited by 19 · see citing works
Changes in sleep duration and changes in weight in obese patients: The Swedish Obese Subjects Study
MARSHALL, N. S., GRUNSTEIN, R. R., PELTONEN, M., STENLOF, K., HEDNER, J., & SJOSTROM, L. V. (2010) · Sleep and Biological Rhythms · doi:10.1111/j.1479-8425.2010.00431.x · Cited by 17 · see citing works
- Authors
- Björkelund, C., Bondyr-Carlsson, D., Lapidus, L., Lissner, L., Månsson, J., Skoog, I., & Bengtsson, C.
- Affiliations
- Department of Primary Health Care, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
- University of Gothenburg (SE)
- Nordic School of Public Health (SE)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-11-01
- Volume
- 28
- Issue
- 11
- Pages
- 2739-2744
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2127786676
- Cited by
- 158
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 3 · 2022: 2 · 2021: 11 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 2 · 2016: 8 · 2015: 14 · 2014: 10 · 2013: 13 · 2012: 14
- FWCI
- 11.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet
- Riksbankens Jubileumsfond
- Sahlgrenska Akademin
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- sleep disorders, diabetes incidence, middle-aged women, obesity, abdominal obesity, waist-to-hip ratio, sleep duration, sleep medication
- MeSH terms
- Adult, Blood Glucose, Blood Pressure, Cholesterol, Cross-Sectional Studies, Diabetes Mellitus, Fasting, Female, Follow-Up Studies, Heart Rate, Humans, Interviews as Topic, Middle Aged, Obesity, Population Surveillance, Prospective Studies, Surveys and Questionnaires, Regression Analysis, Risk Factors, Sleep Wake Disorders, Smoking, Socioeconomic Factors, Sweden, Triglycerides, Urban Population, Cohort Studies, Body Mass Index, Incidence, Waist-Hip Ratio
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