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

A population-based study

  1. Alexandros N. Vgontzas, MD1,
  2. Duanping Liao, MD, PHD2,
  3. Slobodanka Pejovic, MD1,
  4. Susan Calhoun, PHD1,
  5. Maria Karataraki, PSYCHD1 and
  6. Edward O. Bixler, PHD1
  1. 1Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, Pennsylvania;
  2. 2Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
  1. Corresponding author: Alexandros N. Vgontzas, avgontzas{at}


OBJECTIVE We examined the joint effects of insomnia and objective short sleep duration, the combination of which is associated with higher morbidity, on diabetes risk.

RESEARCH DESIGN AND METHODS A total of 1,741 men and women randomly selected from Central Pennsylvania were studied in the sleep laboratory. Insomnia was defined by a complaint of insomnia with duration of ≥1 year, whereas poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into three categories: ≥6 h of sleep (top 50% of the sample); 5–6 h (approximately third quartile of the sample); and ≤5 h (approximately the bottom quartile of the sample). Diabetes was defined either based on a fasting blood glucose >126 mg/dl or use of medication. In the logistic regression model, we simultaneously adjusted for age, race, sex, BMI, smoking, alcohol use, depression, sleep-disordered breathing, and periodic limb movement.

RESULTS Chronic insomnia but not poor sleep was associated with a higher risk for diabetes. Compared with the normal sleeping and ≥6 h sleep duration group, the highest risk of diabetes was in individuals with insomnia and ≤5 h sleep duration group (odds ratio [95% CI] 2.95 [1.2–7.0]) and in insomniacs who slept 5–6 h (2.07 [0.68–6.4]).

CONCLUSIONS Insomnia with short sleep duration is associated with increased odds of diabetes. Objective sleep duration may predict cardiometabolic morbidity of chronic insomnia, the medical impact of which has been underestimated.


  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received February 13, 2009.
    • Accepted July 13, 2009.
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  1. Diabetes Care vol. 32 no. 11 1980-1985
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