Cross-Sectional Associations Between Measures of Sleep and Markers of Glucose Metabolism Among Subjects With and Without Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study

• Published in: Diabetes care Vol. 34; no. 5; pp. 1171 - 1176
• Main Authors: KNUTSON, Kristen L, VAN CAUTER, Eve, ZEE, Phyllis, LIU, Kiang, LAUDERDALE, Diane S
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.05.2011
• Subjects: Actigraphy; Adult; Biological and medical sciences; blood; Blood Glucose; Blood Glucose - metabolism; clinical examination; coronary vessels; Cross-Sectional Studies; Dextrose; Diabetes; Diabetes Mellitus; Diabetes Mellitus - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; fasting; Fasting - blood; Female; Glucose; Glucose metabolism; Humans; Insomnia; Insulin; Insulin - blood; Insulin resistance; Insulin Resistance - physiology; Male; Medical sciences; Metabolic diseases; metabolism; Middle Aged; middle-aged adults; Miscellaneous; noninsulin-dependent diabetes mellitus; Original Research; Physiological aspects; physiology; physiopathology; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk; Risk factors; sleep; Sleep - physiology; Sleep disorders; Sleep Initiation and Maintenance Disorders; Sleep Initiation and Maintenance Disorders - physiopathology; Studies; Teenagers; young adults; Youth; Illinois; Endocrinopathy; Human; Nutrition; Diabetes mellitus; Coronary artery; Biological marker; Metabolic diseases; Risk; Glucose; Metabolism; Association; Sleep; Cross sectional study; Young adult; Risk factor; Sleep wake cycle; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc10-1962

To examine whether sleep duration and quality are associated with fasting glucose, fasting insulin, or estimated insulin resistance in a community-based sample of early middle-aged adults. This was an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Habitual sleep duration and fragmentation were estimated from 6 days of wrist actigraphy collected in 2003-2005. Insomnia was defined as self-reported difficulty falling asleep or waking up in the night three or more times per week plus average sleep efficiency of <80% based on actigraphy. Fasting blood samples to measure glucose and insulin were collected after the sleep measures during the CARDIA clinical examination in 2005-2006. Insulin resistance was estimated using the homeostatic model assessment (HOMA) method. Analyses were cross-sectional and stratified by the presence of diabetes. There was no association between sleep measures and fasting glucose, insulin, or HOMA in the 115 subjects without diabetes. Among the 40 subjects with diabetes, after adjustment for covariates, 10% higher sleep fragmentation was associated with a 9% higher fasting glucose level, a 30% higher fasting insulin level, and a 43% higher HOMA level. Insomnia was associated with a 23% higher fasting glucose level, a 48% higher fasting insulin level, and an 82% higher HOMA level. The observed association between poor sleep quality and higher glucose, insulin, and estimated insulin resistance among subjects with diabetes warrants further examination of the effect of sleep disturbances on glucose control in type 2 diabetes.