Advertisement

Sleep and Breathing

, Volume 23, Issue 1, pp 349–354 | Cite as

Association between insomnia and type 2 diabetes mellitus in Han Chinese individuals in Shandong Province, China

  • Yanhong Zhang
  • Yuanyuan Lin
  • Jianwu Zhang
  • Li Li
  • Xinxin Liu
  • Tianhe WangEmail author
  • Zhenzhong GaoEmail author
Epidemiology • Original Article
  • 115 Downloads

Abstract

Purpose

Diabetes and sleep disorders are public health threats worldwide, but the potential association between them is still unclear.

Methods

We conducted a community-based cross-sectional study including 5078 participants (2665, 52.5% male) to determine the association between insomnia and diabetes mellitus prevalence.

Results

In patients with type 2 diabetes mellitus (T2DM) and nondiabetic controls, the prevalence of insomnia was 20.2% (68/377) and 12.2% (578/4741), respectively. The results showed that insomnia was associated with T2DM after adjusting for age, sex, BMI, smoking, alcohol consumption, presence of disease history (hypertension, dyslipidemia, stroke, cardiovascular diseases, cancers), and depression (odds ratio [OR] = 1.31, 95% confidence interval [CI] 1.03–1.66). After stratifying by age and sex, insomnia was significantly associated with diabetes mellitus only in the subgroup of middle-aged participants (40–59 years) (OR = 1.61, 95% CI 1.16–2.23) and males (OR = 1.48, 95% CI 1.08–2.03) after controlling for the above covariates.

Conclusions

This study suggests that insomnia is independently and significantly associated with diabetes mellitus in the northern Chinese population, especially in the 40–59-year-old age group and in males.

Keywords

Insomnia Sleep duration Diabetes mellitus Athens insomnia scale Cross-sectional study 

Notes

Funding

This work was supported by the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2015BAI06B05). The sponsor had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Weifang Maternity and Child Health Hospital and with the 1964 Declaration of Helsinki and its later amendments or with comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    van Dieren S, Beulens JW, van der Schouw YT, Grobbee DE, Neal B (2010) The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil 17:S3–S8Google Scholar
  2. 2.
    Luyster FS, Strollo PJ, Zee PC, Walsh JK (2012) Boards of directors of the American Academy of Sleep Medicine and the Sleep Research Society. Sleep: a health imperative. Sleep 35:727–734CrossRefGoogle Scholar
  3. 3.
    Holliday EG, Magee CA, Kritharides L, Banks E, Attia J (2013) Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PLoS One 8:e82305CrossRefGoogle Scholar
  4. 4.
    Jackson CL, Redline S, Kawachi I, Hu FB (2013) Association between sleep duration and diabetes in black and white adult. Diabetes Care 36:3557–3565CrossRefGoogle Scholar
  5. 5.
    Buxton OM, Pavlova M, Reid EW, Wang W, Simonson DC, Adler GK (2010) Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes 59:2126–2133CrossRefGoogle Scholar
  6. 6.
    Lin CL, Tsai YH, Yeh MC (2016) Associations between sleep duration and type 2 diabetes in Taiwanese adults: a population-based study. J Formos Med Assoc 115:779–785CrossRefGoogle Scholar
  7. 7.
    Kim WH, Kim BS, Kim SK, Chang SM, Lee DW, Cho MJ, Bae JN (2013) Prevalence of insomnia and associated factors in a community sample of elderly individuals in South Korea. Int Psychogeriatr 2:1729–1737CrossRefGoogle Scholar
  8. 8.
    von Ruesten A, Weikert C, Fietze I, Boeing H (2012) Association of sleep duration with chronic diseases in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. PLoS One 7:e30972CrossRefGoogle Scholar
  9. 9.
    Lou P, Chen P, Zhang L, Zhang P, Yu J, Zhang N, Wu H, Zhao J (2012) Relation of sleep quality and sleep duration to type 2 diabetes: a population-based cross-sectional survey. BMJ Open 2:e000956CrossRefGoogle Scholar
  10. 10.
    Lin Y, Xu Y, Chen G, Lai X, Huang B, Chen Z, Yao L, Zhu S, Yao J, Wen J, Huang H, Lin C (2012) Diabetes and its chronic complications in the She Ethnic Minority Group in China. Diabetes Technol Ther 14:430–439CrossRefGoogle Scholar
  11. 11.
    Engeda J, Mezuk B, Ratliff S, Ning Y (2013) Association between duration and quality of sleep and the risk of pre-diabetes: evidence from NHANES. Diabet Med 30:676–680CrossRefGoogle Scholar
  12. 12.
    Liu J, Hay J, Faught BE (2013) The association of sleep disorder, obesity status, and diabetes mellitus among US adult-the NHANES 2009-2010 survey results. Int J Endocrinol 2013:234129Google Scholar
  13. 13.
    Zhang J, Lam SP, Li SX, Yu MW, Li AM, Ma RC, Kong AP, Wing YK (2012) Long-term outcomes and predictors of chronic insomnia: a prospective study in Hong Kong Chinese adult. Sleep Med 13:455–462CrossRefGoogle Scholar
  14. 14.
    Plantinga L, Rao MN, Schillinger D (2012) Prevalence of self-reported sleep problems among people with diabetes in the United States, 2005-2008. Prev Chronic Dis 9:110244Google Scholar
  15. 15.
    American Diabetes Association (2014) Standards of medical care in diabetes—2014. Diabetes Care 37:S14–S80CrossRefGoogle Scholar
  16. 16.
    Chung KF, Kan KK, Yeung WF (2011) Assessing insomnia in adolescents: comparison of insomnia severity index, Athens insomnia scale and sleep quality index. Sleep Med 12:463–470CrossRefGoogle Scholar
  17. 17.
    Portocarrero AN, Jimenez-Genchi A (2005) Translation into Spanish and validity of the Athens Insomnia Scale. Salud Ment 28:34–39Google Scholar
  18. 18.
    James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311:507–520CrossRefGoogle Scholar
  19. 19.
    Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PW, American College of Cardiology/American Heart Association Task Force on Practice Guidelines (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol 63:2889–2934CrossRefGoogle Scholar
  20. 20.
    Lai YJ, Lin CL, Lin MC, Lee ST, Sung FC, Chang YJ, Kao CH (2013) Population-based cohort study on the increase in the risk for type 2 diabetes mellitus development from nonapnea sleep disorders. Sleep Med 14:913–918CrossRefGoogle Scholar
  21. 21.
    Cespedes EM, Dudley KA, Sotres-Alvarez D, Zee PC, Daviglus ML, Shah NA, Talavera GA, Gallo LC, Mattei J, Qi Q, Ramos AR, Schneiderman N, Espinoza-Giacinto RA, Patel SR (2016) Joint associations of insomnia and sleep duration with prevalent diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Diabetes 8:387–397CrossRefGoogle Scholar
  22. 22.
    Green MJ, Espie CA, Popham F, Robertson T, Benzeval M (2017) Insomnia symptoms as a cause of type 2 diabetes incidence: a 20 year cohort study. BMC Psychiatry 17:94CrossRefGoogle Scholar
  23. 23.
    Narisawa H, Komada Y, Miwa T, Shikuma J, Sakurai M, Odawara M, Inoue Y (2017) Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes. Neuropsychiatr Dis Treat 13:1873–1880CrossRefGoogle Scholar
  24. 24.
    Lin CL, Chien WC, Chung CH, Wu FL (2018) Risk of type 2 diabetes in patients with insomnia: a population-based historical cohort study. Diabetes Metab Res Rev.  https://doi.org/10.1002/dmrr.2930
  25. 25.
    Deng HB, Tam T, Zee BC, Chung RY, Su X, Jin L, Chan TC, Chang LY, Yeoh EK, Lao XQ (2017) Short sleep duration increases metabolic impact in healthy adults: a population-based cohort study. Sleep 40:zsx130Google Scholar
  26. 26.
    Vgontzas AN, Liao D, Pejovic S, Calhoun S, Karataraki M, Bixler EO (2009) Insomnia with objective short sleep duration is associated with type 2 diabetes: a population-based study. Diabetes Care 32:1980–1985CrossRefGoogle Scholar
  27. 27.
    Nilsson PM, Röös M, Engström G, Hedblad B, Berglund G (2004) Incidence of diabetes in middle-aged men is related to sleep disturbances. Diabetes Care 27:2464–2469CrossRefGoogle Scholar
  28. 28.
    Björkelund C, Bondyr-Carlsson D, Lapidus L, Lissner L, Månsson J, Skoog I, Bengtsson C (2005) Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg. Diabetes Care 28:2739–2744CrossRefGoogle Scholar
  29. 29.
    Amin A, Ali A, Altaf QA, Piya MK, Barnett AH, Raymond NT, Tahrani AA (2017) Prevalence and associations of obstructive sleep apnea in South Asians and White Europeans with type 2 diabetes: a cross-sectional study. J Clin Sleep Med 13:583–589CrossRefGoogle Scholar
  30. 30.
    Cho YW, Kim KT, Moon HJ, Korostyshevskiy VR, Motamedi GK, Yang KI (2018) Comorbid insomnia with obstructive sleep apnea: clinical characteristics and risk factors. J Clin Sleep Med 14:409–417CrossRefGoogle Scholar
  31. 31.
    Nagayoshi M, Punjabi NM, Selvin E, Pankow JS, Shahar E, Iso H, Folsom AR, Lutsey PL (2016) Obstructive sleep apnea and incident type 2 diabetes. Sleep Med 25:156–161CrossRefGoogle Scholar
  32. 32.
    Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM (2013) Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC Pulm Med 13:10CrossRefGoogle Scholar
  33. 33.
    Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian A (2016) Sleep disturbances compared to traditional risk factors for diabetes development: systematic review and meta-analysis. Sleep Med Rev 30:11–24CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Deparment of Internal MedicineWeifang Maternity and Child Health HospitalWeifangChina
  2. 2.Deparment of NeurosurgeryWeifang Hospital of Traditional Chinese MedicineWeifangChina
  3. 3.Department of Brain EMGAnqiu People’s HospitalAnqiuChina

Personalised recommendations