Mortality rates rise with too little, too much sleep for adults with type 2 diabetes
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Adults with type 2 diabetes with extreme sleep durations are at higher risk for death than those without diabetes, according to a study published in Diabetologia.
“Although relative mortality risks for extreme — too much or too little — sleep duration are weaker in adults with vs. without diabetes, absolute impact of extreme sleep duration is greater and translates into a major mortality burden,” Chuanhua Yu, PhD, professor in the department of epidemiology and biostatistics in the School of Health Sciences, Wuhan University in Hubei, China, told Healio.
Yu and colleagues defined extreme sleep duration as sleeping 5 hours or less or 10 hours or more per day. For the study, the researchers analyzed data from 273,029 participants in the National Health Interview Survey conducted from 2004 to 2013 who had information linked to a mortality database through 2015. The group included 24,212 adults with and 248,817 without type 2 diabetes.
Researchers looked at all-cause mortality as well as eight cause-specific mortality rates: cardiovascular disease, cancer, heart disease, stroke, chronic lower respiratory disease, Alzheimer’s disease, influenza and pneumonia, and kidney disease. Sleep duration was self-reported and categorized into six groups, with the shortest duration 5 hours or less and the longest 10 hours or more per day.
Researchers found mortality rates for adults with and without type 2 diabetes increased with extreme sleep durations. However, the increases were more pronounced among those with type 2 diabetes. Using adults without diabetes who reported sleeping 7 hours per day as a reference, the study showed participants with type 2 diabetes who slept 10 hours or more (HR = 2.17; 95% CI, 1.72-2.73) or 5 hours or less per day (HR = 1.63; 95% CI, 1.24-2.13) had higher risks for death when compared with adults without diabetes who slept 10 or more hours (HR = 1.9; 95% CI, 1.62-2.23) and 5 hours or less per day (HR = 1.33; 95% CI, 1.13-1.56).
Participants who were diagnosed with type 2 diabetes at age 45 years or younger had higher all-cause mortality rates at 5 hours or less (HR = 1.37; 95% CI, 1.05-1.79) and 10 hours or more sleep per day (HR = 2.08; 95% CI, 1.61-2.71) than those diagnosed at older ages who slept 5 hours or less (HR = 1.19; 95% CI, 1.02-1.38) and 10 hours or more per day (HR = 1.73; 95% CI, 1.5-2).
Adults with type 2 diabetes duration of 11 to 20 years (HR = 2.18; 95% CI, 1.73-2.74) and more than 20 years (HR = 1.88; 95% CI, 1.49-2.37) had the largest increases in all-cause mortality when they slept 10 or more hours per day. Sleeping 10 hours or more per day was also linked to the highest cause-specific mortality rate increase among adults with type 2 diabetes, including CVD (HR = 1.74; 95% CI, 1.33-2.28), stroke (HR = 2.95; 95% CI, 1.63-5.34), Alzheimer’s disease (HR = 2.64; 95% CI, 1.14-6.08) and kidney disease (HR = 5.18; 95% CI, 2.18-12.28).
Study participants treated with both oral glucose medication and insulin had higher HRs in all-cause mortality for both short (HR = 1.55; 95% CI, 1.09-2.2) and long sleep durations (HR = 1.8; 95% CI, 1.32-2.45) vs. those treated with one medication. A similar increase was observed with the CVD mortality rate increase.
“Achievement of a healthy sleep habit is recommended in adults with or without type 2 diabetes,” Yu said. “In addition, these individuals with a younger age at diabetes onset and receiving treatment with both oral glucose-lowering medication and insulin may require greater medical attention that targets sleep and lifestyle to reduce the risks of adverse health outcomes.”
For more information:
Chuanhua Yu, PhD, can be reached at Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan 430071, Hubei, China; email: yuchua@whu.edu.cn.
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