Insomnia With Objective Short Sleep Duration Is Associated With Type 2 Diabetes

Vgontzas, Alexandros N.; Liao, Duanping; Pejovic, Slobodanka; Calhoun, Susan L.; Karataraki, Maria; Bixler, Edward O.

doi:10.2337/dc09-0284

Cited by 472 publications

(382 citation statements)

References 26 publications

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“…However, the mean TST in the insomnia group was greater than 5h, and no sub-group analysis was performed to compare TST below and above 5h 26 . In fact, an objective sleep duration of less than 5 h is necessary to increase the risk of diabetes 8,27 . The severity of sleep disturbance is a key component in metabolic control, as only severe sleep apnea is clearly related to the risk of impaired glucose metabolism 28 .…”

Section: Discussionmentioning

confidence: 99%

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Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia

D’Aurea¹,

Poyares²,

Piovezan³

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective To evaluate the association between objective short sleep duration in patients with insomnia and changes in blood parameters related to hypothalamic-pituitary-adrenal (HPA) axis activity.Method A cross-sectional pilot study was conducted in 30 middle-aged adults with chronic insomnia who were divided into 2 groups according to polysomnography (PSG) total sleep time (TST) (TST > 5h and < 5h). All patients underwent subjective analysis of sleep quality, anthropometric measurements, PSG, and determination off asting blood parameters.Results The results revealed lower sleep efficiency and higher sleep latency for those with a TST < 5h. The subjective sleep quality was worse in the TST < 5h. Significantly, higher glucose and cortisol levels were observed with a TST < 5h. Glucose, cortisol and ACTH levels were inversely correlated with the PSG total sleep time.Conclusion Patients with insomnia with objective short sleep duration had HPA-associated endocrine and metabolic imbalances chronically linked to increases in cardiovascular risk observed with this more severe insomnia phenotype.

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Section: Discussionmentioning

confidence: 99%

“…A cross-sectional analysis revealed that insomnia with objective short sleep duration is associated with an increased risk of diabetes 8 . Hypothalamic-pituitary-adrenal (HPA) axis activity plays a role in hypertension and diabetes development 9,10 .…”

mentioning

confidence: 99%

Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia

D’Aurea¹,

Poyares²,

Piovezan³

et al. 2015

Arq. Neuro-Psiquiatr.

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“…[5][6][7][8][9][10][11] A large population-based Norwegian study suggested that after adjusting for confounding factors, insomnia remained a significant risk factor for rheumatic diseases, including fibromyalgia (odds ratio [OR], 2.05; 95 % confidence interval [CI], 1.51-2.79) and rheumatoid arthritis (OR, 1.87; 95 % CI, 1.29-2.52). 8 However, there is no systemic longitudinal evidence linking chronic insomnia with autoimmune diseases (AID).…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Risk of Autoimmune Disease in Adults with Chronic Insomnia Requiring Sleep-Inducing Pills: A Population-Based Longitudinal Study

et al. 2016

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BACKGROUND: Recent studies indicate that chronic insomnia is associated with the development of certain somatic diseases. Whether it would be associated with the development of an autoimmune disease (AID) was unknown. OBJECTIVE: We aimed to examine the association and quantify the magnitude of risk for AID in individuals suffering from chronic insomnia requiring sleep-inducing pills. DESIGN: This was a population-based, nationwide longitudinal study. PARTICIPANTS: Using a claims data set containing 1 million randomly sampled, insured subjects derived from the National Health Insurance Research Database, we assembled a chronic insomnia group and a 1:3 propensity score-matched comparison group (CP), which were balanced in terms of sex, age, insurance premium, urbanization, alcohol use disorder, smoking-related diagnoses, and morbid obesity. MAIN MEASURES: Person-time data with incidence rate, adjusted hazard ratios (aHR) by the Cox model, AID-free survival functions compared with the log-rank test, and a sensitivity analysis on the time lag effect were presented. Incident AID within the first year of follow-up were excluded. The error rate was controlled using the BenjaminiHochberg procedure. KEY RESULTS: With 39,550 and 129,914 person-years' follow-up for the chronic insomnia and CP groups (n = 5,736 and 17,208), respectively, we found an increased risk for subsequent AID, representing a 70 % increase in the aHR (1.7; 95 % confidence interval [CI], 1.5-1.9, p < 0.0001). A positive association between chronic insomnia and primary Sjögren's syndrome (pSS) was observed (aHR, 1.3; 95 % CI, 1.1-1.6). Sensitivity analysis disclosed that AID risk was even stronger after 5 years of follow-up (aHR, 2.0; 95 % CI, 1.7-2.4). CONCLUSION:Chronic insomnia requiring sleepinducing pills may be associated with a 70 % increased risk for future AID, particularly pSS.KEY WORDS: chronic insomnia; autoimmune disease; population-based study; propensity score matching; Sjögren's syndrome.

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“…This is consistent with findings from our longitudinal analysis that poor sleep quality significantly increased the risk of diabetes. The cross-sectional study by Vgontzas et al, 136 did not find individual associations between insomnia and diabetes, or sleep duration and diabetes, but after examining the joint effects of insomnia and sleep duration, they found that compared to normal sleeping subjects (sleep duration of >6 hours), those with insomnia and with short sleep duration (<5 hours) were at increased risk of diabetes. Our sleep quality variable was composed of items other than insomnia and although we did not stratify on number of hours of sleep, we found a significant relationship between poor sleep quality and diabetes after adjusting for confounders including sleep duration.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, sleep duration and sleep quality have often been analyzed separately in both longitudinal and cross-sectional studies, and only very few studies have incorporated aspects of both sleep duration and quality into their analyses 135,136 . Sleep duration is measured by the number of hours a person sleeps in a day, and does not take into account the nature of the sleep.…”

Section: Resultsmentioning

confidence: 99%

Markers and mechanisms of metabolic aging.

Ahiawodzi

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ACKNOWLEDGEMENTSMy first and foremost thanks go to Almighty God for His love and for giving me strength throughout my doctoral study. I am also grateful for the love and support from family and friends. To my son Carl and my wife Jennifer I say, thank you for giving me encouragement and standing by me through difficult times.This dissertation would not be complete without the tireless efforts of Dr. RichardKerber. Words will not be enough to describe your guidance, patience, and expertize.You opened your doors to me, gave me some materials to read, and opened my eyes to this special field of research in free radical biology. Your office hours were not restricted and you stop whatever you are doing to listen to me whenever I walk in. Individuals like you are hard to come by and I must say that I am privileged to have you as my dissertation committee chair.There were other inspirational individuals on my dissertation committee who contributed in countless ways to get this dissertation completed; Dr. Taylor kept me on my toes because I had to prepare something to show to her every Wednesday; Dr.O'Brien always kept me thinking outside the box to get a complete picture of things; Dr.Groves would ask me mechanistic questions that would send me to the library and come out enlightened; and Dr. Mukamal despite being an external committee member made himself so available and I cannot count the number of times I sent e-mails to him at iv midnight hoping to get a response in the morning, but just to see him respond in the blink of an eye; I have learnt a lot from all of you and I will forever be grateful. Oxidative stress has been implicated in aging and age-related diseases. Using three distinct studies, this dissertation examines associations between lifestyle factors and oxidative stress, and their effects on advanced glycation end products, telomere length, and type II diabetes.Carboxymethyl-lysine (CML), an advanced glycation end-product, has been linked to oxidative stress, cardiovascular and other age-related diseases. The first study investigates the association between sleep disordered breathing (SDB), a source of oxidative stress, and CML. 1002 participants with sleep data from the Cardiovascular Health Study (CHS) were analyzed. SDB was not significantly associated with CML, but after stratification by gender and hemoglobin it was found that among female subjects with higher hemoglobin levels, those with more severe SDB had a significantly higher CML concentration, while the reverse was observed among males.Telomere length is another biomarker of cumulative exposure to oxidative stress and an indicator of aging. In the second study, 974 participants from the Framingham vi Heart Study were analyzed to investigate the role of modifiable factors known to affect oxidative stress including obesity, cigarette smoking, excessive alcohol consumption, and physical inactivity, on telomere length. Age, gender, BMI, and alcohol consumption were found to significantly influence telomere length.Diabetes and its complications h...

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Insomnia With Objective Short Sleep Duration Is Associated With Type 2 Diabetes

Cited by 472 publications

References 26 publications

Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia

Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia

Risk of Autoimmune Disease in Adults with Chronic Insomnia Requiring Sleep-Inducing Pills: A Population-Based Longitudinal Study

Markers and mechanisms of metabolic aging.

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