Short Sleep Duration is Associated with the Development of Impaired Fasting Glucose: The Western New York Health Study

Purpose

To examine whether sleep duration was associated with incident-impaired fasting glucose (IFG) over 6 years of follow-up in the Western New York Health Study.

Methods

Participants (N = 1,455, 68% response rate) who were free of type 2 diabetes and known cardiovascular disease at baseline (1996–2001) were reexamined in the period 2003–2004. A nested case-control study was conducted. Cases had fasting plasma glucose (FPG) less than 100 mg/dL at baseline and 100 to 125 mg/dL at follow-up: controls (n = 272) had FPG less than 100 mg/dL at both exams. Cases (n = 91) were individually matched to three controls (n = 272) on sex, race, and year of study enrollment. Average sleep duration was categorized as short (<6 hours), mid-range (6 to 8 hours), and long (>8 hours).

Results

In multivariate conditional logistic regression after adjustment for several diabetes risk factors, the odds ratio (OR) of IFG among short sleepers was 3.0 (95% confidence limit [CL]: 1.05, 8.59) compared to mid-range sleepers. There was no association between long sleep and IFG: OR 1.6 (95% CL: 0.45, 5.42). Adjustment for insulin resistance attenuated the association only among short sleepers: OR 2.5 (95% CL: 0.83, 7.46).

Conclusions

Short sleep duration was associated with an elevated risk of IFG. Insulin resistance appears to mediate this association.

Key Words: Glucose Metabolism, Impaired Fasting Glucose, Nested Case-Control Study, Population-Based Sleep Duration

Selected Abbreviations and Acronyms: BMI, body mass index, CES-D, Center for Epidemiologic Studies Depression Scale, CI, confidence interval, FPG, fasting plasma glucose, HOMA-IR, homeostasis model assessment insulin resistance, HTN, hypertension, IFG, impaired fasting glucose, IGT, impaired glucose tolerance, OGTT, oral glucose tolerance test, OR, odds ratio, PA, physical activity, RR, relative risk