Association of short sleep duration with impaired glucose tolerance or diabetes mellitus

Sleep status and its association with dietary habits among children and adolescents in Shandong Province, China: a cross-sectional study

BACKGROUND

Insufficient sleep is a widespread issue among children and adolescents, influenced by various factors, including dietary habits. This study aimed to examine the relationship between dietary habits and sleep insufficiency in children and adolescents aged 6 to 18 in Shandong Province, China.

METHODS

Data were derived from a 2024 survey assessing sleep status among children and adolescents in Shandong Province. the prevalence of insufficient sleep was determined, and univariable Χ² test was used to explore associations between daily life behaviors and sleep duration. Multivariable logistic regression was employed to analyze the effect of specific dietary habits on sleep insufficiency, adjusting for potential confounding factors.

RESULTS

The overall prevalence of insufficient sleep was 53.28%. After adjusting for confounders, the logistic regression model indicated that regular breakfast consumption 4 ~ 6 times per week (OR = 0.578, 95% CI 0.522 ~ 0.640) or every day (OR = 0.502, 95% CI: 0.450 ~ 0.561) was associated with significantly lower odds of insufficient sleep. Higher vegetable intake more than five times per week (OR = 0.376, 95% CI: 0.338 ~ 0.418) and fruit consumption 4 ~ 5 times per week (OR = 0.866, 95% CI: 0.816 ~ 0.918) or more than five times per week (OR = 0.446, 95% CI: 0.405 ~ 0.490) were also linked to reduced odds of insufficient sleep. Conversely, higher sugary beverage consumption 4 ~ 5 times per week (OR = 2.066, 95% CI: 1.903 ~ 2.243) or more than five times per week (OR = 2.021, 95% CI: 1.838 ~ 2.223) significantly increased the likelihood of insufficient sleep. Fast food consumption 2 ~ 3 times per week (OR = 1.025, 95% CI: 1.003 ~ 1.048) or more than three times per week (OR = 1.036, 95% CI: 1.002 ~ 1.071) was also associated with higher odds of insufficient sleep (P < 0.05).

CONCLUSION

Dietary habits significantly influence sleep duration among children and adolescents in Shandong Province. Regular breakfast consumption, increased intake of vegetable and fruit, and reduced consumption of sugary beverage and fast food were associated with improved sleep duration. These findings underscored the importance of promoting healthy eating behaviors as a key strategy for addressing sleep-related issues and improving overall well-being in young populations.

Sleep duration and food intake in people with type 2 diabetes mellitus and factors affecting confectionery intake

AIMS/INTRODUCTION

We carried out a cross-sectional study of people with type 2 diabetes mellitus to elucidate the association between sleep duration and food intake.

MATERIALS AND METHODS

Overall, 2,887 participants with type 2 diabetes mellitus (mean age 63.0 years; 61.1% men; mean glycated hemoglobin level 7.5%) were included in this study. The participants' self-reported dietary habits and sleep duration were evaluated using a brief self-administered dietary history questionnaire and Pittsburgh Sleep Quality Index, respectively. The participants were categorized into the following four groups based on sleep duration: <6, 6-6.9, 7-7.9 (reference) and ≥8 h.

RESULTS

No significant differences were observed between the groups regarding energy intake (kcal/day), absolute intake (g/day) or relative intake (% energy) of carbohydrates, total fat, proteins and fibers. However, confectionery intake was higher in the <6 h group and lower in the ≥8 h group than in the reference group after adjustment for confounding factors. In multivariate analysis, sleep durations <6 h and ≥8 h significantly correlated with increased (95% confidence interval 0.55 to 3.6; P = 0.0078) and decreased (95% confidence interval -4.0 to -0.32; P = 0.021) confectionery intake, respectively. Confectionery intake was positively correlated with female sex, glycated hemoglobin level and dyslipidemia, whereas it was negatively correlated with alcohol consumption and current smoking status.

CONCLUSIONS

Short sleep duration is associated with high confectionery intake in people with type 2 diabetes mellitus; this might disturb their glycemic control. Therefore, short sleepers with type 2 diabetes mellitus could improve their glycemic control by avoiding confectionery intake and maintaining adequate sleep duration.

Adaptive Solutions to the Problem of Vulnerability During Sleep

Sleep is a behavioral state whose quantity and quality represent a trade-off between the costs and benefits this state provides versus the costs and benefits of wakefulness. Like many species, we humans are particularly vulnerable during sleep because of our reduced ability to monitor the external environment for nighttime predators and other environmental dangers. A number of variations in sleep characteristics may have evolved over the course of human history to reduce this vulnerability, at both the individual and group level. The goals of this interdisciplinary review paper are (1) to explore a number of biological/instinctual features of sleep that may have adaptive utility in terms of enhancing the detection of external threats, and (2) to consider relatively recent cultural developments that improve vigilance and reduce vulnerability during sleep and the nighttime. This paper will also discuss possible benefits of the proposed adaptations beyond vigilance, as well as the potential costs associated with each of these proposed adaptations. Finally, testable hypotheses will be presented to evaluate the validity of these proposed adaptations.

A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus

OBJECTIVE

To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis.

METHODS

PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3.

RESULTS

A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) (t ≤ 6 h), 4.39% in normal sleep duration (NSD) (6 h < t < 9 h), and 4.99% in long sleep duration (LSD) (t ≥ 9 h). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD (RR = 1.22, 95% CI: 1.15-1.29, P < 0.001), LSD increased the risk of T2DM compared with NSD (RR = 1.26, 95% CI: 1.15-1.39, P < 0.001), and the risk of T2DM has no significant difference between SSD and LSD (RR = 0.97, 95% CI: 0.89-1.05, P = 0.41). The sensitivity of each study was robust and the publication bias was weak.

CONCLUSION

SSD or LSD can increase the risk of T2DM.

Effect of Social Factors and the Natural Environment on the Etiology and Pathogenesis of Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is currently a public health problem worldwide and a threat to human health and social development. The incidence rate of the disease is steadily increasing. Various genetic and environmental factors have been established as influencing the pathogenesis of this disease. However, the influence of social factors and the natural environment on DM incidence should also be considered. Low-grade inflammation could represent a central point of connection integrating all these potential triggers, being partly responsible for the development of insulin resistance. This paper aims to elaborate on the impact of the natural environment and social factors on DM development, with a special focus on six aspects of the pathogenesis of DM: pollution, radiation, psychology, drink, sleep, and exercise. We identified a two-way relationship between T2DM and social and natural environments. Changes in these environments may lead to low-grade inflammation, which in turn induces or aggravates T2DM and vice versa. Poor lifestyle may lead to increased insulin resistance and promote DM development. Improvements in blood glucose control can be achieved through nonenvironmental and behavioral interventions.

Association between sleep duration during pregnancy and gestational diabetes mellitus: a meta-analysis

OBJECTIVE

Sleep is critical for glucose metabolism. Pregnant women often have sleep disturbances and extreme sleep duration. Investigations of the relationship between sleep duration during pregnancy and gestational diabetes mellitus (GDM) have reported inconsistent results. The present study aimed to meta-analyze the relationship between sleep duration during pregnancy and GDM risk.

METHODS

We performed a systematic search of the PubMed, ISI Web of Science, and PsycINFO databases for studies that were published up to October 2017, that reported associations between sleep duration during pregnancy and GDM risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed.

RESULTS

A total of 4366 papers were retrieved, among which seven studies assessed the relationship between sleep duration during pregnancy and GDM development. The seven articles included 18,203 subjects at baseline and 1294 GDM cases during follow-up. Compared to normal sleep duration, extreme sleep duration during early and middle pregnant stages had a close relationship with GDM based upon pooled data from prospective and cross-sectional studies. Prospective results showed that long sleep duration during pregnancy was a risk factor for GDM, but not short sleep duration. Publication biases were found when analyzing the relationship between extreme sleep duration and GDM.

CONCLUSIONS

Extreme sleep duration during pregnancy is closely associated with GDM. Moreover, long but not short sleep duration can predict the risk of developing GDM. These findings remind us of the importance of sleep duration control during pregnancy and help optimize early strategies for the prevention of GDM.

Associations between actigraphy-assessed sleep, inflammatory markers, and insulin resistance in the Midlife Development in the United States (MIDUS) study

BACKGROUND

Disturbed sleep has been associated with increased insulin resistance and elevated inflammation. Although there is growing body of evidence that activation of inflammatory pathways plays a crucial role in the development of insulin resistance, the mediational model whereby sleep disturbances influence inflammation that drives insulin resistance has not been fully assessed in general population studies with objectively measured sleep. This study aimed to examine associations between objectively measured sleep, inflammatory markers, and insulin resistance simultaneously and in a mediational analysis, thereby offering insights into the possible causal model.

METHODS

Cross-sectional data collected from 2004 to 2009 during the Midlife Development in the United States II biomarker project were used. The study population included 374 community-based participants (138 men and 236 women) who completed seven nights of wrist actigraphy. Multiple regressions controlling for age and statistically significant variables in univariate regressions were performed to evaluate the associations between actigraphy-assessed sleep measures, inflammatory cytokines, and insulin resistance.

RESULTS

The regression models showed that in women, higher sleep onset latency (SOL) was associated with higher insulin resistance after controlling for age, smoking, obesity, diabetes, depression, and inflammatory cytokines. Higher SOL was also associated with higher interleukin (IL)-6 and C-reactive protein (CRP) levels in women, but no association was found in men. Using mediation models in women, the association between SOL and insulin resistance was partially explained by the indirect effect of inflammatory cytokines.

CONCLUSION

A combination of inflammation and other unidentified pathways may contribute to the relationship between disturbed sleep and glucose homeostasis.

The impact of sleep duration on recovery post-hip fracture among older diabetic adults in Taiwan

This study explored postoperative changes in sleep duration and physical activity and their relationships with physical function recovery, the muscular strength of the affected side and blood glucose control in elderly adults (n = 41) with diabetes mellitus (DM) who underwent surgery for hip fracture. Thirty-two participants (78.0%) had abnormal sleep durations for at least two time points, and they all had low physical activity levels (an average of 1348.2 kcal/day for the first month, 1377.9 kcal/day for the third month, and 1389.1 kcal/day for the sixth month) during the six months post-hip fracture. The participants with normal sleep durations showed greater femoral muscle improvement on the affected side (adduction: β = 3.70, p = 0.029; abduction: β = 7.25, p = 0.016) and better blood glucose control before meals (β = -73.29, p < 0.001) and after meals (β = -47.90, p = 0.007) compared with those with abnormal sleep durations. Those with higher physical activity levels had better physical function recovery.

The association between mental health, chronic disease and sleep duration in Koreans: a cross-sectional study

Background

Sleep duration holds considerable importance as an indicator of mental/physical health. The objective of this study was to investigate the association between sleep duration, mental health, and chronic disease prevalence in Koreans.

Methods

Of 31,596 subjects eligible for the Korean National Health and Nutrition Examination Survey V (2010–2012), 17,638 participants who answered items on sleep duration (aged ≥19 yrs) were analyzed in a cross-sectional study. Association between sleep duration, mental health, and chronic disease prevalence was assessed using logistic regression, and adjusted for various socioeconomic and lifestyle characteristics.

Results

Short or long sleep duration showed correlations with mental health, and items of significance showed gender-specific patterns. Women displayed significant associations with stress and depressive symptoms, and men with stress, thoughts of suicide, and psychiatric counseling. While stress was related with short sleep duration in both genders, depressive symptoms showed a relationship with long duration in men, and short duration in women. Prevalence of any chronic disease was associated with ≤6 h sleep when adjusted for factors including mental health, and among chronic diseases, cancer and osteoarthritis showed associations with short sleep duration, while diabetes and dyslipidemia were associated with normal sleep duration.

Conclusions

Mental health problems were associated with sleep duration with gender-specific patterns. Associations with osteoarthritis, cancer, diabetes, dyslipidemia and abnormal sleep duration persisted after adjustment for mental health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2542-3) contains supplementary material, which is available to authorized users.