Sleep duration and diabetes
Both long and short sleep duration may be related to diabetes incidence. Long sleep duration was positively associated with insulin resistance, as recently shown in the study of 2848 individuals [6]. In the other study, encompassing 355 type 2 diabetes (t2D) patients and 43 patients with impaired glucose tolerance, poor glycemic control, defined as
glycated hemoglobin (HbA1c) level ≥ 7.0%, was markedly associated with short sleep duration [7]. In the population-based cohort study of 162 121 non-obese adults, short sleep duration (<6 hours/day) significantly (p<0.001) increased the risk of elevated levels of fasting glucose by 6% [8]. In the Chinese study of 19 257 participants, both short and long sleep duration was associated with an increased incidence of t2D [9]. But in the other analysis of 53 260 adults in China increased risk of diabetes was associated only with
short (< 6 hours), but not with long sleep duration [10]. One night reduction in the sleep duration decreases insulin sensitivity [11], and subchronic sleep deprivation, lasting up to 8 days, causes peripheral insulin resistance [12].
Also, pre-diabetes occurs more frequently in people who sleep less than 5 hours per day [13].
Sleep quality and diabetes
Sleep quality strongly influences the risk of diabetes.
The study of 2291 adults in the mean age of 46.3±5.1 years
revealed an increased risk of diabetes among subjects with chronically non-restorative sleep [14]. Poor sleep quality, as measured by a self-administered questionnaire, was associated with poor glycemic control in t2D patients [7]. There is a strong relationship between sleep quality and glycemic control in adult t2D patients [15]. A comparison of the group of 622 adult t2D patients and 622 age and sex-matched controls revealed poorer sleep quality in diabetic patients, as measured by the Pittsburgh Sleep Quality Index (PSQI) [16-18]. The study performed in 347 obese and overweight women with metabolic syndrome revealed significant correlation of insulin resistance with poor sleep quality, as assessed by Medical Outcomes Study Sleep Scale; especially sleep latency over 30 min, restless sleep and daytime sleepiness were all related to the homeostatic model assessment of insulin resistance (HOMA2-IR) values [19]. Multiple awakenings during the night reduce the sensitivity of cells to insulin [20].
Insomnia and diabetes
Primary insomnia seems to be one of the possible risk factors for developing diabetes. Patients with insomnia, especially younger than 40 years or with chronic insomnia lasting >8 years, were found to be at higher risk of developing t2D than the patients without insomnia [21]. Increased risk of diabetes was associated with difficulties in falling asleep and with early morning awakening [10]. However, in the study of the patients with primary insomnia and normal polysomnography (PSG) recording, neither diabetes nor glucose intolerance were found [22].
Ref
Curr Neuropharmacol. 2021 Jan;19(1):78–91. doi: 10.2174/1570159X18666200309101750
Sleep Disturbances and Cognitive Impairment in the Course of Type 2 Diabetes-A Possible Link
Anna Brzecka 1,*, Natalia Madetko 2, Vladimir N Nikolenko 3,4, Ghulam M Ashraf 5, Maria Ejma 2, Jerzy Leszek 6, Cyryl Daroszewski 1, Karolina Sarul 1, Liudmila M Mikhaleva 7, Siva G Somasundaram 8, Cecil E Kirkland 8, Sergey O Bachurin 9, Gjumrakch Aliev 3,7,9,10
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