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© 2004 by the American Diabetes Association, Inc.
Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes |
Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances
1 Department of Medicine, University Hospital, Malmö, Sweden
2 Department of Community Medicine, University Hospital, Malmö, Sweden
Address correspondence and reprint requests to Peter M. Nilsson, MD, PhD, Department of Medicine, University Hospital, S-205 02 Malmö, Sweden. E-mail: peter.nilsson{at}medforsk.mas.lu.se
OBJECTIVE—Sleep deprivation in healthy men has been experimentally found to result in disturbances in glucose metabolism and in sympathovagal imbalance. The aim of the present study was to investigate whether sleep disturbances and elevated resting heart rate are associated with increased risk of developing diabetes.
RESEARCH DESIGN AND METHODS—A group of 6,599 initially healthy, nondiabetic men aged 44.5 ± 4.0 years took part in a prospective, population-based study in Malmö, Sweden. The incidence of diabetes during a mean follow-up of 14.8 ± 2.4 years was examined in relation to self-reported difficulties in falling asleep and resting heart rate at baseline. Diabetes was assessed at follow-up in all subjects by questionnaire and in a subgroup of 1,551 men by blood glucose measurement.
RESULTS—A total of 615 (9.3%) subjects reported either difficulties in falling asleep or regular use of hypnotics (seen as markers of sleep disturbances), and 158 (2.4%) subjects reported both of these. Altogether, 281 (4.3%) of the men developed diabetes during the follow-up period. Logistic regression models showed difficulties in falling asleep or regular use of hypnotics (odds ratio [OR] 1.52 [95% CI 1.05–2.20]) and resting heart rate (OR per 10 bpm 1.13 [0.99–1.30]) to be associated with development of diabetes when full adjustments were made for baseline age, biological risk factors, lifestyle, family history of diabetes, and social class.
CONCLUSIONS—The results suggest that sleep disturbances and, possibly, elevated resting heart rate, in middle-aged men, are associated with an increased risk of diabetes.
Abbreviations: HPA, hypothalamopituitary adrenal • MDC, Malmö Diet and Cancer • MPP, Malmö Preventive Project • OGTT, oral glucose tolerance test • OSA, obstructive sleep apnea • SNA, sympathetic nervous activation
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