Abstract
Our objective was to evaluate the associations between habitual daytime napping and diabetes and whether it varies by sex, menopause, and sleep quality. We conducted a population-based cross-sectional study in 8621 eligible individuals aged 40 years or older. Information on daytime napping hours, night-time sleep duration, history of menstruation, and sleep quality was self-reported. Diabetes was diagnosed according to the 1999 World Health Organization diagnostic criteria. The prevalence of diabetes was 19.4 % in men and 15.6 % in women. Increased daytime napping hours were positively associated with parameters of glycometabolism in women, such as fasting plasma glucose, oral glucose tolerance test (OGTT) 2-h plasma glucose, and Hemoglobin A1c (HbA1c, all P for trend <0.05). In women, the prevalence of diabetes in no-habitual daytime napping group, 0–1-h daytime napping group, and more than 1-h daytime napping group were 14.5, 15.6, and 20.8 %, respectively (P for trend = 0.0004). A similar trend was detected in postmenopausal women (P for trend = 0.002). In multivariate logistic regression analysis, compared with no-habitual daytime napping postmenopausal women, those with daytime napping more than 1 h had higher prevalent diabetes (odds ratios 1.36, 95 % confidence interval, 1.04–1.77). In subgroup analysis of postmenopausal women, associations of daytime napping levels and prevalent diabetes were detected in older, overweight participants with good sleep quality who have not retired from work. In conclusion, our study suggests that habitual daytime napping is associated with prevalence of diabetes in postmenopausal women.
Similar content being viewed by others
References
X.R. Pan, W.Y. Yang, G.W. Li, J. Liu, Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group. Diabetes Care 20(11), 1664–1669 (1997)
W. Yang, J. Lu, J. Weng et al., Prevalence of diabetes among men and women in China. N. Engl. J. Med. 362(12), 1090–1101 (2010)
R. Lozano, M. Naghavi, K. Foreman et al., Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859), 2095–2128 (2012)
Q. Xu, Y. Song, A. Hollenbeck, A. Blair, A. Schatzkin, H. Chen, Day napping and short night sleeping are associated with higher risk of diabetes in older adults. Diabetes Care 33(1), 78–83 (2010)
A.H. Shadyab, D. Kritz-Silverstein, G.A. Laughlin, W.J. Wooten, E. Barrett-Connor, M.R. Araneta, Ethnic-specific associations of sleep duration and daytime napping with prevalent type 2 diabetes in postmenopausal women. Sleep Med. 16(2), 243–249 (2015)
S.E. Goldman, M. Hall, R. Boudreau et al., Association between nighttime sleep and napping in older adults. Sleep 31(5), 733–740 (2008)
K.B. Lam, C.Q. Jiang, G.N. Thomas et al., Napping is associated with increased risk of type 2 diabetes: the Guangzhou Biobank Cohort Study. Sleep 33(3), 402–407 (2010)
A.B. Newman, P.L. Enright, T.A. Manolio, E.F. Haponik, P.W. Wahl, Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study. J. Am. Geriatr. Soc. 45(1), 1–7 (1997)
E.F. Saunders, J. Fernandez-Mendoza, M. Kamali, S. Assari, M.G. McInnis, The effect of poor sleep quality on mood outcome differs between men and women: a longitudinal study of bipolar disorder. J. Affect. Disord. 180, 90–96 (2015)
S. Nowakowski, C.J. Meliska, L.F. Martinez, B.L. Parry, Sleep and menopause. Curr. Neurol. Neurosci. Rep. 9(2), 165–172 (2009)
H.M. Kravitz, P.A. Ganz, J. Bromberger, L.H. Powell, K. Sutton-Tyrrell, P.M. Meyer, Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause 10(1), 19–28 (2003)
G. Ning, Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. J. Diabetes 4(2), 172–173 (2012)
Y. Bi, J. Lu, W. Wang et al., Cohort profile: risk evaluation of Cancers in chinese diabetic individuals: a longitudinal (reaction) study. J. Diabetes 6(2), 147–157 (2014)
K. Sun, F. Li, D. Lin et al., Serum gamma - glutamyltransferase is associated with albuminuria: a population-based study. PLoS One 9(12), e114970 (2014)
K. Sun, J. Liu, G. Ning, Active smoking and risk of metabolic syndrome: a meta-analysis of prospective studies. PLoS One 7(10), e47791 (2012)
K. Tomioka, J. Iwamoto, K. Saeki, N. Okamoto, Reliability and validity of the international physical activity questionnaire (IPAQ) in elderly adults: the Fujiwara-kyo study. J. Epidemiol. 21(6), 459–465 (2011)
J. Lu, Y. Bi, T. Wang et al., The relationship between insulin-sensitive obesity and cardiovascular diseases in a chinese population: results of the reaction study. Int. J. Cardiol. 172(2), 388–394 (2014)
B.F. Zhou, Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases–report for meta-analysis of prospective studies open optimal cut-off points of body mass index in chinese adults. Biomed. Environ. Sci. 15(3), 245–252 (2002)
C. Chen, F.C. Lu, The guidelines for prevention and control of overweight and obesity in chinese adults. Biomed. Environ. Sci. 17(Suppl), 1–36 (2004)
J.C. Levy, D.R. Matthews, M.P. Hermans, Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 21(12), 2191–2192 (1998)
H.K. Yaggi, A.B. Araujo, J.B. McKinlay, Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care 29(3), 657–661 (2006)
J.E. Gangwisch, S.B. Heymsfield, B. Boden-Albala et al., Sleep duration as a risk factor for diabetes incidence in a large US. sample. Sleep 30(12), 1667–1673 (2007)
T.Y. Lan, T.H. Lan, C.P. Wen, Y.H. Lin, Y.L. Chuang, Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. Sleep 30(9), 1105–1110 (2007)
D. Trichopoulos, A. Tzonou, C. Christopoulos, S. Havatzoglou, A. Trichopoulou, Does a siesta protect from coronary heart disease? Lancet 2(8553), 269–270 (1987)
A. Liu, C.A. Kushida, G.M. Reaven, Habitual shortened sleep and insulin resistance: an independent relationship in obese individuals. Metabolism 62(11), 1553–1556 (2013)
E. Van Cauter, J.D. Blackman, D. Roland, J.P. Spire, S. Refetoff, K.S. Polonsky, Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep. J. Clin. Invest. 88(3), 934–942 (1991)
D.L. Woods, H. Kim, M. Yefimova, To nap or not to nap: excessive daytime napping is associated with elevated evening cortisol in nursing home residents with dementia. Biol. Res. Nurs. 15(2), 185–190 (2013)
A. Caufriez, R. Leproult, M. L’Hermite-Baleriaux, M. Kerkhofs, G. Copinschi, Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. J. Clin. Endocrinol. Metab. 96(4), E614–E623 (2011)
M.P. Diamond, D. Grainger, M.C. Diamond, R.S. Sherwin, R.A. Defronzo, Effects of methyltestosterone on insulin secretion and sensitivity in women. J. Clin. Endocrinol. Metab. 83(12), 4420–4425 (1998)
D.N. Polesel, C. Hirotsu, K.T. Nozoe et al., Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women: a cross-sectional population-based study. Menopause 22(8), 1 (2015)
F. Valham, B. Stegmayr, M. Eriksson, E. Hagg, E. Lindberg, K.A. Franklin, Snoring and witnessed sleep apnea is related to diabetes mellitus in women. Sleep Med. 10(1), 112–117 (2009)
K.P. Davy, J.S. Orr, Sympathetic nervous system behavior in human obesity. Neurosci. Biobehav. Rev. 33(2), 116–124 (2009)
G.S. Stergiou, S.E. Mastorantonakis, L.G. Roussias, Intraindividual reproducibility of blood pressure surge upon rising after nighttime sleep and siesta. Hypertens. Res. 31(10), 1859–1864 (2008)
E.A. Lucassen, K.I. Rother, G. Cizza, Interacting epidemics? Sleep curtailment, insulin resistance, and obesity. Ann. N. Y. Acad. Sci. 1264, 110–134 (2012)
A.G. Tabak, T.N. Akbaraly, G.D. Batty, M. Kivimaki, Depression and type 2 diabetes: a causal association? Lancet Diabetes Endocrinol. 2(3), 236–245 (2014)
Greco, C., Spallone, V. Obstructive Sleep Apnoea Syndrome and Diabetes. Fortuitous Association or Interaction? Curr. Diabetes Rev. [Epub ahead of print] (2015)
Acknowledgments
We are indebted to the participants in the present study for their persistent outstanding support and to our colleagues working for their valuable assistance.
Author contributions
Conceived and designed the experiments: L. Y., Y. L., and K. S.; Performed the experiments: D. L., F. L., Y. Q., M. R., FP. L., and M. X.; Analyzed the data: K. S. and D. L. Wrote the manuscript: K. S. and F. L.
Funding
This work was supported by grants from 1. the National Natural Science Foundation of China (81471034, 81370910,81300675); 2. Major project of the people’s livelihood science and technology in Guangzhou (201300000102); 3. the Zhu jiang Star of science and technology Foundation in Guang Zhou (2014J2200046); 4.the Natural Science Foundation of Guangdong Province (S2013010016443); 5.Young Teacher Cultivation Project of Sun Yat-sen University (12ykpy28); and 6.grants from the Chinese Society of Endocrinology and National Clinical Research Center for Metabolic Diseases. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All of the authors have no relevant conflict of interest.
Additional information
Kan Sun and Feng Li are equally contributed.
Rights and permissions
About this article
Cite this article
Sun, K., Li, F., Qi, Y. et al. Sex difference in the association between habitual daytime napping and prevalence of diabetes: a population-based study. Endocrine 52, 263–270 (2016). https://doi.org/10.1007/s12020-015-0772-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12020-015-0772-x