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30-07-2020 | Diabetes | News | Article

More evidence linking sleep duration with mortality risk in type 2 diabetes

medwireNews: Getting too little or too much sleep is associated with higher death rates among adults with type 2 diabetes when compared to individuals without diabetes, according to data from a large prospective cohort study.

The hazard ratios (HRs) for all-cause mortality were 1.63 for adults with diabetes who slept for less than 5 hours in every 24 versus those without who slept for 7 hours and 2.17 for people with diabetes who slept for 10 hours or longer.

Having diabetes and sleeping for 6, 8, or 9 hours a day was associated with respective HRs of 1.59, 1.56, and 1.74. These associations were significant and independent of factors including age, education and income, BMI, physical activity, and coronary heart disease.

“A J-shaped relationship existed between sleep duration and all-cause mortality risk in people with type 2 diabetes,” Xiong Chen (The First Affiliated Hospital of Wenzhou Medical University, China) and co-authors write in Diabetologia.

To look at the relationship between sleep and mortality risk in people with diabetes, Wang et al used data on more than 273,000 adults collated by the US National Health Interview Survey between 2004 and 2013 that had included information on people’s self-reported sleeping habits. They then linked the information to the National Death Index database, using data up to the end of 2015. In all, their sample set consisted of 24,212 people with and 248,817 without type 2 diabetes.

The absolute mortality risk in people with type 2 diabetes at the extremes of sleep duration each day was 215.0 per 10,000 person–years for those getting 5 hours or less and 363.5 per 10,000 person–years for those getting 10 hours or more. Mortality risk was also increased at the extremes of sleep duration in those without diabetes, but to a lesser extent (122.2 and 255.5 per 10,000 person–years, respectively).

Wang and team also looked at how sleep duration affected mortality due to special causes, such as cardiovascular disease (CVD), cancer, kidney disease, Alzheimer’s disease, and chronic lower respiratory diseases. They found high rates in people with type 2 diabetes with the longest sleep duration (≥10 hours), particularly in those who had been diagnosed under the age of 45 years and those who had been treated with oral antidiabetic drugs or insulin. CVD-specific mortality risk was also high in older (>45 years) people with diabetes who slept for more than 10 hours per day.

These data provide “preliminary evidence that the associations between sleep duration and mortality risk are different between people with and without diabetes,” say Wang et al.

This could mean that people with type 2 diabetes, particularly those who had a younger age of onset or are being treated with glucose-lowering medications, “may require more medical attention targeting sleep and lifestyle to reduce the risks of adverse outcomes.”

By Sara Freeman

medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group

Diabetologia 2020; doi:10.1007/s00125-020-05214-4

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