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Self-reported sleep characteristics are linked to type 2 diabetes in middle-aged and elderly individuals: a cross-sectional study based on NHANES

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Abstract

Objective

This study was aimed to evaluate the link between sleep characteristics and type 2 diabetes of middle-aged and elderly individuals.

Methods

Twenty thousand four hundred ninety-seven individuals enrolled in National Health and Nutritional Examination Survey (NHANES) form periods of 2005–2008 were included in this study, and 3965 individuals aged 45 years and older with complete data were detected. Variables related to sleep characteristics were analyzed by univariate analysis to identify the risk factors of type 2 diabetes, the logistic regression model was used to test for the tendency across the sections of sleep duration, and the link between sleep duration and risk of type 2 diabetes was manifested as odds ratio (OR) and 95% confidence interval (CI).

Results

Six hundred ninety-four individuals with type 2 diabetes were identified and enrolled in the type 2 diabetes group, while the remaining individuals (n = 3271) were enrolled in the non-type 2 diabetes group. Individuals in the type 2 diabetes group (63.9 ± 10.2) were older than those in the non-type 2 diabetes group (61.2 ± 11.5, P < 0.001). Factors of taking longer time to fall asleep (P < 0.001), sleeping less (≤ 4 h) or more (≥ 9 h) (P < 0.001), having trouble in falling asleep (P = 0.001), frequent snoring (P < 0.001), frequent sleep apnea (P < 0.001), frequent nighttime awakenings (P = 0.004), and frequent excessive daytime sleepiness (P < 0.001) were linked to the risk of type 2 diabetes.

Conclusion

Our study revealed that sleep characteristics were closely linked to type 2 diabetes in middle-aged and elderly individuals, and a longer sleep duration might have protective effects against type 2 diabetes, but it should be constrained within 9 h/night.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Hanafy MM, Lindeque JZ, El-Maraghy SA, Abdel-Hamid AZ, Shahin NN (2021) Time-based investigation of urinary metabolic markers for type 2 diabetes: metabolomics approach for diabetes management. BioFactors 47:645–657

    Article  CAS  PubMed  Google Scholar 

  2. Paing AC, Kirk AF, Collier A, Kubiak T, Chastin SFM (2018) Are glucose profiles well-controlled within the targets recommended by the International Diabetes Federation in type 2 diabetes? A meta-analysis of results from continuous glucose monitoring based studies. Diabetes Res Clin Pract 146:289–299

    Article  CAS  PubMed  Google Scholar 

  3. Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graziani F, Herrera D, Jepsen S, Lione L, Madianos P, Mathur M, Montanya E, Shapira L, Tonetti M, Vegh D (2018) Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol 45:138–149

    Article  CAS  PubMed  Google Scholar 

  4. Zhao X, Huo L, Yu X, Zhang X (2021) Association of bone metabolism indices and bone mineral density with diabetic retinopathy in elderly patients with type 2 diabetes mellitus: a cross-sectional inpatient study in China. J Diabetes Res 2021:8853622

    PubMed  PubMed Central  Google Scholar 

  5. Tao YEM, Shi J, Zhang Z (2021) Sulfonylureas use and fractures risk in elderly patients with type 2 diabetes mellitus: a meta-analysis study. Aging Clin Exp Res 33:2133–2139

    Article  PubMed  Google Scholar 

  6. Zhang Y, Pan XF, Chen J, Xia L, Cao A, Zhang Y, Wang J, Li H, Yang K, Guo K, He M, Pan A (2020) Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia 63:21–33

    Article  PubMed  Google Scholar 

  7. Zhang SB, Chen H, Xu HW, Yi YY, Fang XY, Wang SJ (2022) Computed tomography-based paravertebral muscle density predicts subsequent vertebral fracture risks independently of bone mineral density in postmenopausal women following percutaneous vertebral augmentation. Aging Clin Exp Res 34:2797–2805

    Article  PubMed  Google Scholar 

  8. Parker D, Bucks RS, Rainey-Smith SR, Hodgson E, Fine L, Sohrabi HR, Martins RN, Weinborn M (2021) Sleep Mediates age-related executive function for older adults with limited cognitive reserve. J Int Neuropsychol Soc 27:711–721

    Article  PubMed  Google Scholar 

  9. Scullin MK, Bliwise DL (2015) Sleep, cognition, and normal aging: integrating a half century of multidisciplinary research. Perspect Psychol Sci 10:97–137

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhang S, Xie L, Yu H, Zhang W, Qian B (2019) Association between nighttime-daytime sleep patterns and chronic diseases in Chinese elderly population: a community-based cross-sectional study. BMC Geriatr 19:124

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lu C, Liao B, Nie J, Wang W, Wang Y (2020) The association between sleep duration and chronic diseases: a population-based cross-sectional study. Sleep Med 73:217–222

    Article  PubMed  Google Scholar 

  12. Chen X, Wang SB, Li XL, Huang ZH, Tan WY, Lin HC, Hou CL, Jia FJ (2020) Relationship between sleep duration and sociodemographic characteristics, mental health and chronic diseases in individuals aged from 18 to 85 years old in Guangdong province in China: a population-based cross-sectional study. BMC Psychiatry 20:455

    Article  PubMed  PubMed Central  Google Scholar 

  13. Holliday EG, Magee CA, Kritharides L, Banks E, Attia J (2013) Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PLoS ONE 8:e82305

    Article  PubMed  PubMed Central  Google Scholar 

  14. Maskarinec G, Jacobs S, Amshoff Y, Setiawan VW, Shvetsov YB, Franke AA, Kolonel LN, Haiman CA, Le Marchand L (2018) Sleep duration and incidence of type 2 diabetes: the multiethnic cohort. Sleep Health 4:27–32

    Article  PubMed  Google Scholar 

  15. Barone MT, Menna-Barreto L (2011) Diabetes and sleep: a complex cause-and-effect relationship. Diabetes Res Clin Pract 91:129–137

    Article  PubMed  Google Scholar 

  16. Schaller L, Arzt M, Jung B, Böger CA, Heid IM, Stadler S (2021) Long-Term weight change and glycemic control in patients with type 2 diabetes mellitus and treated vs. untreated sleep-disordered breathing-analysis from the DIAbetes COhoRtE. Front Neurol 12:745049

  17. Li CI, Lin CC, Liu CS, Lin CH, Yang SY, Li TC (2022) Sleep duration predicts subsequent long-term mortality in patients with type 2 diabetes: a large single-center cohort study. Cardiovasc Diabetol 21:60

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Gil-Lozano M, Hunter PM, Behan LA, Gladanac B, Casper RF, Brubaker PL (2016) Short-term sleep deprivation with nocturnal light exposure alters time-dependent glucagon-like peptide-1 and insulin secretion in male volunteers. Am J Physiol Endocrinol Metab 310:E41–50

    Article  PubMed  Google Scholar 

  19. Shigiyama F, Kumashiro N, Tsuneoka Y, Igarashi H, Yoshikawa F, Kakehi S, Funato H, Hirose T (2018) Mechanisms of sleep deprivation-induced hepatic steatosis and insulin resistance in mice. Am J Physiol Endocrinol Metab 315:E848–E858

    Article  CAS  PubMed  Google Scholar 

  20. Zhang YW, Lu PP, Li YJ, Wang H, Zhao YK, Chen H, Rui YF (2023) Short report: relationship between self-reported sleep characteristics and falls-associated fractures in elderly individuals: a population-based study. Psychol Health Med 28:946–954

    Article  PubMed  Google Scholar 

  21. Zhang YW, Lu PP, Li YJ, Dai GC, Cao MM, Xie T, Zhang C, Shi L, Rui YF (2021) Low dietary choline intake is associated with the risk of osteoporosis in elderly individuals: a population-based study. Food Funct 12:6442–6451

    Article  CAS  PubMed  Google Scholar 

  22. Xu C, Liang J, Xu S, Liu Q, Xu J, Gu A (2020) Increased serum levels of aldehydes are associated with cardiovascular disease and cardiovascular risk factors in adults. J Hazard Mater 400:123134

    Article  CAS  PubMed  Google Scholar 

  23. Tseng CH, Chong CK, Tseng CP, Tai TY (2008) The association between urinary albumin excretion and ankle-brachial index in elderly Taiwanese patients with type 2 diabetes mellitus. Age Ageing 37:77–82

    Article  PubMed  Google Scholar 

  24. Samuel-Hodge CD, Headen SW, Skelly AH, Ingram AF, Keyserling TC, Jackson EJ, Ammerman AS, Elasy TA (2000) Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multi-caregiver role, and other social context factors. Diabetes Care 23:928–933

    Article  CAS  PubMed  Google Scholar 

  25. Zhang YW, Cao MM, Li YJ, Chen XX, Yu Q, Rui YF (2022) A narrative review of the moderating effects and repercussion of exercise intervention on osteoporosis: ingenious involvement of gut microbiota and its metabolites. J Transl Med 20:490

    Article  PubMed  PubMed Central  Google Scholar 

  26. Zhang YW, Cao MM, Li YJ, Lu PP, Dai GC, Zhang M, Wang H, Rui YF (2022) Fecal microbiota transplantation ameliorates bone loss in mice with ovariectomy-induced osteoporosis via modulating gut microbiota and metabolic function. J Orthop Translat 37:46–60

    Article  PubMed  PubMed Central  Google Scholar 

  27. Zhang YW, Cao MM, Li YJ, Zhang RL, Wu MT, Yu Q, Rui YF (2022) Fecal microbiota transplantation as a promising treatment option for osteoporosis. J Bone Miner Metab 40:874–889

    Article  PubMed  PubMed Central  Google Scholar 

  28. Liu M, Ahmed WL, Zhuo L, Yuan H, Wang S, Zhou F (2022) Association of sleep patterns with type 2 diabetes mellitus: a cross-sectional study based on latent class analysis. Int J Environ Res Public Health 20

  29. Zhao S, Fu S, Ren J, Luo L (2018) Poor sleep is responsible for the impaired nocturnal blood pressure dipping in elderly hypertensive: a cross-sectional study of elderly. Clin Exp Hypertens 40:582–588

    Article  PubMed  Google Scholar 

  30. Lou P, Chen P, Zhang L, Zhang P, Chang G, Zhang N, Li T, Qiao C (2014) Interaction of sleep quality and sleep duration on impaired fasting glucose: a population-based cross-sectional survey in China. BMJ Open 4:e004436

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kita T, Yoshioka E, Satoh H, Saijo Y, Kawaharada M, Okada E, Kishi R (2012) Short sleep duration and poor sleep quality increase the risk of diabetes in Japanese workers with no family history of diabetes. Diabetes Care 35:313–318

    Article  PubMed  PubMed Central  Google Scholar 

  32. Reutrakul S, Van Cauter E (2018) Sleep influences on obesity, insulin resistance, and risk of type 2 diabetes. Metabolism 84:56–66

    Article  CAS  PubMed  Google Scholar 

  33. Cottet S, Dupraz P, Hamburger F, Dolci W, Jaquet M, Thorens B (2002) cFLIP protein prevents tumor necrosis factor-alpha-mediated induction of caspase-8-dependent apoptosis in insulin-secreting betaTc-Tet cells. Diabetes 51:1805–1814

    Article  CAS  PubMed  Google Scholar 

  34. Liu M, Jing D, Wang Y, Liu Y, Yin S (2015) Overexpression of angiotensin II type 2 receptor promotes apoptosis and impairs insulin secretion in rat insulinoma cells. Mol Cell Biochem 400:233–244

    Article  CAS  PubMed  Google Scholar 

  35. Antza C, Kostopoulos G, Mostafa S, Nirantharakumar K, Tahrani A (2021) The links between sleep duration, obesity and type 2 diabetes mellitus. J Endocrinol 252:125–141

    Article  PubMed  PubMed Central  Google Scholar 

  36. Orzeł-Gryglewska J (2010) Consequences of sleep deprivation. Int J Occup Med Environ Health 23:95–114

    Article  PubMed  Google Scholar 

  37. Moraes DA, Venancio DP, Suchecki D (2014) Sleep deprivation alters energy homeostasis through non-compensatory alterations in hypothalamic insulin receptors in Wistar rats. Horm Behav 66:705–712

    Article  CAS  PubMed  Google Scholar 

  38. Tan X, Chapman CD, Cedernaes J, Benedict C (2018) Association between long sleep duration and increased risk of obesity and type 2 diabetes: a review of possible mechanisms. Sleep Med Rev 40:127–134

    Article  PubMed  Google Scholar 

  39. Bayrak M, Çadirci K (2022) Quality of sleep in elderly patients with diabetes mellitus from Turkey: a cross-sectional observational study. Exp Aging Res 48:373–386

    Article  PubMed  Google Scholar 

  40. Gu KM, Min SH, Cho J (2022) Sleep duration and mortality in patients with diabetes: results from the 2007–2015 Korea national health and nutrition examination survey. Diabetes Metab 48:101312

    Article  PubMed  Google Scholar 

  41. Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian A (2016) Sleep disturbances compared to traditional risk factors for diabetes development: systematic review and meta-analysis. Sleep Med Rev 30:11–24

    Article  PubMed  Google Scholar 

  42. Grandner MA, Jackson NJ, Pak VM, Gehrman PR (2012) Sleep disturbance is associated with cardiovascular and metabolic disorders. J Sleep Res 21:427–433

    Article  PubMed  Google Scholar 

  43. Henderson LA, Macefield VG (2016) Obstructive sleep apnoea and hypertension: the role of the central nervous system. Curr Hypertens Rep 18:59

    Article  PubMed  Google Scholar 

  44. Khalil M, Power N, Graham E, Deschênes SS, Schmitz N (2020) The association between sleep and diabetes outcomes - a systematic review. Diabetes Res Clin Pract 161:108035

    Article  PubMed  Google Scholar 

  45. Tsereteli N, Vallat R, Fernandez-Tajes J, Delahanty LM, Ordovas JM, Drew DA, Valdes AM, Segata N, Chan AT, Wolf J, Berry SE, Walker MP, Spector TD, Franks PW (2022) Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions. Diabetologia 65:356–365

    Article  CAS  PubMed  Google Scholar 

  46. Lee SWH, Ng KY, Chin WK (2017) The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: a systematic review and meta-analysis. Sleep Med Rev 31:91–101

    Article  PubMed  Google Scholar 

  47. Zhang YW, Cao MM, Li YJ, Dai GC, Lu PP, Zhang M, Bai LY, Chen XX, Shi L, Zhang C, Rui Y-F (2022) Dietary protein intake in relation to the risk of osteoporosis in middle-aged and older individuals: a cross-sectional study. J Nutr Health Aging 26:252–258

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Intensive Care Unit, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China

    Wen-Han Xia & Chun-Li Yang

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  1. Wen-Han Xia
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Correspondence to Chun-Li Yang.

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Ethics approval and consent to participate

This study was conducted in accordance with the principles of Declaration of Helsinki. The NHANES database used in this study did not contain identifiable nor protected the health information and is publicly available for download. In addition, this current study is simply an exempt study and involves secondary processing data, which is approved by Research Ethics Review Board of NCHS and the written informed consent are also provided by the included participants.

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The authors declare no competing interests.

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Xia, WH., Yang, CL. Self-reported sleep characteristics are linked to type 2 diabetes in middle-aged and elderly individuals: a cross-sectional study based on NHANES. Ir J Med Sci 192, 2769–2776 (2023). https://doi.org/10.1007/s11845-023-03352-3

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