Abstract

Short sleep duration (SSD) (<7 hours/night) is linked with increased risk of prediabetes to diabetes progression. Despite a high diabetes burden in US rural women, existing research does not provide SSD estimates for this population. We used national Behavioral Risk Factor Surveillance System surveys to conduct a cross-sectional study examining SSD estimates for US women with prediabetes by rural/urban residence between 2016-2020. We applied logistic regression models to the BRFSS dataset to ascertain associations between rural/urban residence status and SSD prior to and following adjustment for sociodemographic factors (age, race, education, income, health care coverage, having a personal doctor). Our study included 20,997 women with prediabetes (33.7% rural). SSD prevalence was similar between rural (35.5%, 95% CI: 33.0%-38.0%) and urban women (35.4%, 95% CI: 33.7%-37.1). Rural residence was not associated with SSD among US women with prediabetes prior to adjustment (Odds Ratio: 1.00, 95% CI: 0.87-1.14) or following adjustment for sociodemographic factors (Adjusted Odds Ratio: 1.06, 95% CI: 0.92-1.22). Among women with prediabetes, irrespective of rural/urban residence status, being Black, aged <65 years, and earning <$50,000 was linked with significantly higher odds of having SSD. Despite the finding that SSD estimates among women with prediabetes did not vary by rural/urban residence status, 35% of rural women with prediabetes had SSD. Efforts to reduce diabetes burden in rural areas may benefit from incorporating strategies to improve sleep duration along with other known diabetes risk factors among rural women with prediabetes from certain sociodemographic backgrounds.

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