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Sleep quality and risk of diabetes and coronary artery disease among young men

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Abstract

Aims

To assess the time-dependent effect of sleep quality on diabetes and coronary artery disease (CAD) incidence among young adults.

Methods

Incident rates of diabetes and CAD during a mean follow-up of 6.4 ± 4.1 years were assessed among 26,023 men (mean age 30.9 ± 5.6 years) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults stratified by sleep quality at baseline, as assessed by the Mini-Sleep Questionnaire (MSQ). Incident diabetes and CAD were analyzed using a Cox proportional hazard model.

Results

There were 445 cases of diabetes and 92 cases of CAD during 151,312 person-years. An abnormal MSQ score was associated with a 53 % higher incidence of diabetes (95 % CI 1.22–1.94, p < 0.001) compared to those with a normal score, after adjustment for clinical and biochemical diabetes risk factors. The increased risk associated with abnormal sleep quality remained when MSQ was modeled as a continuous time-dependent variable in a multivariable model (HR = 1.036, 95 % CI 1.024–1.049, p < 0.001). The increased risk was higher among overweight or obese participants (BMI and MSQ interaction p = 0.046). Sustained abnormality in MSQ score resulted in higher HR for diabetes (2.35; 95 % CI 1.564–3.519, p < 0.001). In addition, abnormal sleep quality was associated with a 2.38 higher incidence of CAD (95 % CI 1.38–4.11, p = 0.002), after adjustment for traditional clinical and biochemical risk factors.

Conclusions

Sleep quality contributes to the development of diabetes and CAD in apparently healthy young adults in a time-dependent manner. The use of a simple questionnaire to assess sleep quality may be a useful tool for risk stratification in this population.

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Acknowledgments

This study was supported by a research grant of the IDF Medical Corp and the Israeli ministry of defense (GT). GT and AT were partially supported by a grant from the Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer, Israel. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

None.

Ethical standard

The study was approved by the institutional review board of the Israel Defense Forces Medical Corps.

Human and Animal Rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975. The Institutional Review Board of the IDF Medical Corps approved this study and waived the need for informed consent with the assurance of strict maintenance of participants’ anonymity during data analyses.

Informed consent

The need for informed consent was waived from this study on the basis of strict maintenance of participants’ anonymity during database analyses.

Author information

Authors and Affiliations

  1. Department of Medicine B, Sheba Medical Center, 52621, Ramat Gan, Israel

    Gilad Twig

  2. The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel

    Gilad Twig & Amir Tirosh

  3. The Israel Defense Forces Medical Corps, Ramat Gan, Israel

    Gilad Twig, Avi Shina, Estela Derazne & Dorit Tzur

  4. Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel

    Avi Shina

  5. The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Arnon Afek, Estela Derazne & Tali Cukierman-Yaffe

  6. Israel Ministry of Health, Jerusalem, Israel

    Arnon Afek

  7. The Center for Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel

    Tali Cukierman-Yaffe & Amir Tirosh

  8. The Sleep Institute, Sheba Medical Center, Ramat Gan, Israel

    Dalia Shechter-Amir

  9. Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada

    Hertzel C. Gerstein

  10. The Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Amir Tirosh

Authors
  1. Gilad Twig
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  2. Avi Shina
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  3. Arnon Afek
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  6. Tali Cukierman-Yaffe
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  7. Dalia Shechter-Amir
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  8. Hertzel C. Gerstein
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  9. Amir Tirosh
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Corresponding author

Correspondence to Gilad Twig.

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Twig, G., Shina, A., Afek, A. et al. Sleep quality and risk of diabetes and coronary artery disease among young men. Acta Diabetol 53, 261–270 (2016). https://doi.org/10.1007/s00592-015-0779-z

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  • DOI: https://doi.org/10.1007/s00592-015-0779-z

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