Abstract
BackgroundThe effect of sleep on the risk of developing diabetes has not been explored in an Asian population. The objective of this study is to investigate the effect of self-reported sleep duration and sleep quality on the risk of developing diabetes in a prospective cohort in Japan.MethodsData were analyzed from the cohort of participants in a High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP), conducted in Japan from the year 1999 until 2004. A Cox proportional hazard model was used to evaluate the association between sleep duration or sleep quality and the risk of diabetes.ResultsOf 6509 participants (26.1% of women, 19–69 years of age), a total of 230 type 2 diabetes cases were reported over a median 4.2 years of follow-up. For participants who often experienced difficulty in initiating sleep, the multivariate-adjusted hazard ratios for diabetes were 1.42 (95%CI, 1.05–1.91) in participants with a medium frequency of difficulty initiating sleep, and 1.61 (95%CI, 1.00–2.58) for those with a high frequency, with a statistically significant linear trend. Significant association was not observed in the association between difficulty of maintaining sleep or duration of sleep, and risk of diabetes.ConclusionMedium and high frequencies of difficulty initiating sleep, but not difficulty in maintaining sleep or in sleep duration, are associated with higher risks of diabetes in relatively healthy Asian workers, even after adjusting for a large number of possible further factors.
Highlights
The effect of sleep on the risk of developing diabetes has not been explored in an Asian population
For the purpose of validating the questions, we hypothesized that participants experienced a shorter sleep duration if they had poor sleep quality, so that we evaluated the association between difficulty initiating sleep, difficulty maintaining sleep, and sleep duration
We evaluated the joint association between sleep quality or sleep quantity and gender if it was associated with risk of diabetes, because recent studies reported gender differences in sleep disorders [7]
Summary
The effect of sleep on the risk of developing diabetes has not been explored in an Asian population. Since diabetes mellitus carries a high risk of cardiovascular mortality, the impact of sleep restriction on glucose regulation suggests a mechanism whereby short sleep time could increase mortality. Evidence is accumulating concerning the long-term effect of abnormal quality of sleep (e.g. difficulty initiating and maintaining sleep) or quantity of sleep (sleep duration) on the future risk of developing diabetes. Most of these studies were in the USA and Europe [6,7,8], and it is not clear whether the results are applicable to the Asian population. Evidence increasingly suggests that the epidemiology of type 2 diabetes depends on ethnicity [9]
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