Association Between Accelerometer-Measured Irregular Sleep Duration and Type 2 Diabetes Risk: A Prospective Cohort Study in the UK Biobank

Diabetes Care, vol. 47, pp. 1647–1655

Abstract

OBJECTIVE: To evaluate the association between irregular sleep duration and incident diabetes in a U.K. population over 7 years of follow-up. RESEARCH DESIGN AND METHODS: Among 84,421 UK Biobank participants (mean age 62 years) who were free of diabetes at the time of providing accelerometer data in 2013-2015 and prospectively followed until May 2022, sleep duration variability was quantified by the within-person SD of 7-night accelerometer-measured sleep duration. We used Cox proportional hazard models to estimate hazard ratios (HRs) for incident diabetes (identified from medical records, death register, and/or self-reported diagnosis) according to categories of sleep duration SD. RESULTS: There were 2,058 incident diabetes cases over 622,080 person-years of follow-up. Compared with sleep duration SD ≤ 30 min, the HR (95% CI) was 1.15 (0.99, 1.33) for 31-45 min, 1.28 (1.10, 1.48) for 46-60 min, 1.54 (1.32, 1.80) for 61-90 min, and 1.59 (1.33, 1.90) for ≥91 min, after adjusting for age, sex, and race. We found a nonlinear relationship (P nonlinearity 0.0002), with individuals with a sleep duration SD of >60 vs. ≤60 min having 34% higher diabetes risk (95% CI 1.22, 1.47). Further adjustment for lifestyle, comorbidities, environmental factors, and adiposity attenuated the association (HR comparing sleep duration SD of >60 vs. ≤60 min: 1.11; 95% CI 1.01, 1.22). The association was stronger among individuals with lower diabetes polygenic risk score (PRS; P interaction ≤ 0.0264) and longer sleep duration (P interaction ≤ 0.0009). CONCLUSIONS: Irregular sleep duration was associated with higher diabetes risk, particularly in individuals with a lower diabetes PRS and longer sleep duration.

Authors 8

1. Sina Kianersi

   Brigham and Women's Hospital · Harvard University

   Affiliation as printed

   1Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA

   2Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA

2. Heming Wang

   Broad Institute · Brigham and Women's Hospital

   Affiliation as printed

   2Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA

   3Broad Institute of MIT and Harvard, Cambridge, MA

3. Tamar Sofer

   Brigham and Women's Hospital · Harvard University

   Affiliation as printed

   2Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA

   4Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA

4. Raymond Noordam Aachen 5Department of Internal Medicine Section of Gerontology and Geriatrics

   Leiden University Medical Center

   Affiliation as printed

   5Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands

5. Andrew N. Phillips

   Flinders University · Monash University

   Affiliation as printed

   6Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia

   7Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia

6. Martin K. Rutter

   Manchester Academic Health Science Centre · Manchester Royal Infirmary · University of Manchester · Manchester University NHS Foundation Trust · NIHR Manchester Biomedical Research Centre

   Affiliation as printed

   8Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, U.K

   9Diabetes, Endocrinology and Metabolism Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, U.K

7. Susan S Redline

   Brigham and Women's Hospital · Harvard University

   Affiliation as printed

   10Division of Sleep Medicine, Harvard Medical School, Boston, MA

   2Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA

8. Tianyi Huang corresponding

   Brigham and Women's Hospital · Harvard University

   Affiliation as printed

   10Division of Sleep Medicine, Harvard Medical School, Boston, MA

   1Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA