Clinical research study
Race/Ethnicity, Sleep Duration, and Diabetes Mellitus: Analysis of the National Health Interview Survey

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Abstract

Background

The effect of race/ethnicity on the risk of diabetes associated with sleep duration has not been systematically investigated. This study assessed whether blacks reporting short (<6 hours) or long (>8 hours) sleep durations were at greater risk for diabetes than their white counterparts. In addition, this study also examined whether the influence of race/ethnicity on associations between abnormal sleep durations and the presence of diabetes were independent of individuals' sociodemographic and medical characteristics.

Methods

A total of 29,818 Americans (age range: 18-85 years) enrolled in the 2005 National Health Interview Survey, a cross-sectional household interview survey, provided complete data for this analysis.

Results

Of the sample, 85% self-ascribed their ethnicity as white and 15% as black. The average age was 47.4 years, and 56% were female. Results of univariate regression analysis adjusting for medical comorbidities showed that black and white participants who reported short sleep duration (<6 hours) were more likely to have diabetes than individuals who reported sleeping 6 to 8 hours (odds ratios 1.66 and 1.87, respectively). Likewise, black and white participants reporting long sleep duration (>8 hours) had a greater likelihood of reporting diabetes compared with those sleeping 6 to 8 hours (odds ratios 1.68 and 2.33, respectively). Significant interactions of short and long sleep with black and white race were observed. Compared with white participants, greater diabetes risk was associated with being short or long sleepers of black race.

Conclusion

The present findings suggest that American short and long sleepers of black race may be at greater risk for diabetes independently of their sociodemographic profile or the presence of comorbid medical conditions, which have been shown to influence habitual sleep durations. Among black individuals at risk for diabetes, healthcare providers should stress the need for adequate sleep.

Section snippets

Procedures

The NHIS is a cross-sectional household interview survey conducted annually by the National Center for Health Statistics of the Centers for Disease Control and Prevention. It uses a multistage area probability design that provides representative samples of US households. On the basis of this design, probability samples of the civilian population of all 50 states and the District of Columbia were obtained. Details on sample design can be found in Design and Estimation for the NHIS, 1995-2005.16

Participants

A total of 29,818 Americans (age range: 18-85 years) enrolled in the 2005 NHIS provided complete data for this analysis. Of the sample, 85% self-reported their race/ethnicity as white and 15% as black (15%). Among the respondents, the average age was 47.4 years, and 56% were female.

Sociodemographic and health characteristics of study participants are provided in Table 1. Overall, blacks were younger than their white counterparts; blacks were more likely to be female and to report a yearly

Discussion

Our analysis of the 2005 NHIS data showed that participants who report short and long sleep duration are at increased risk for diabetes. Specifically, individuals who report short sleep duration (<6 hours) were nearly twice as likely (odds ratio 1.91) to have diabetes compared with individuals who report normal sleep duration (6-8 hours). Likewise, long sleep duration (>8 hours) was strongly associated with the presence of diabetes (odds ratio 2.25) compared with normal sleep duration. The

Conclusions

Our analysis suggests that sleep should be targeted in the management of diabetes. In particular, a sleep component should be incorporated into treatment management programs, highlighting the need for adequate sleep in reducing the risk of diabetes. Our study shows diabetes risk is higher in black American short and long sleepers than in their white counterparts, and efforts to increase awareness of the link between aberrant sleep and diabetes will be beneficial for blacks, with the most

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    Funding: This research was supported by funding from the National Institutes of Health (R25HL105444 and R01MD004113).

    Conflict of Interest: None.

    Authorship: All authors had access to the data and played a role in writing this manuscript.

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