SLEEP DURATION, LIFESTYLE INTERVENTION AND INCIDENCE OF TYPE 2 DIABETES IN IMPAIRED GLUCOSE TOLERANCE. THE FINNISH DIABETES PREVENTION STUDY.

  1. Henri Tuomilehto, MD, PhD (henri.tuomilehto{at}kuh.fi)1,4,
  2. Markku Peltonen, PhD2,
  3. Markku Partinen, MD, PhD3,
  4. Gilles Lavigne, DMD, PhD4,
  5. Johan G Eriksson, MD, PhD2,5,6,
  6. Christian Herder, PhD7,
  7. Sirkka Aunola, PhD8,
  8. Sirkka Keinänen-Kiukaanniemi, MD, PhD9,
  9. Pirjo Ilanne-Parikka, MD10,
  10. Matti Uusitupa, MD, PhD11,
  11. Jaakko Tuomilehto, MD, PhD1213,
  12. Jaana Lindström, PhD2 and
  13. on the behalf of the Finnish Diabetes Prevention Study Group
  1. 1 Department of Otorhinolaryngology, Kuopio University Hospital, and University of Kuopio, Finland
  2. 2 Diabetes Unit, Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland
  3. 3 Skogby Sleep Clinic, Rinnekoti Research, Espoo, and Department of Neurology, University of Helsinki, Finland
  4. 4 Faculty of Dental Medicine, Université de Montreal, Canada
  5. 5 Department of General Practice and Primary Health Care, University of Helsinki, Finland
  6. 6 Vasa Central Hospital, Vasa, Finland
  7. 7 Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
  8. 8 Laboratory for Population Research, National Public Health Institute, Helsinki, Finland
  9. 9 Institute of Health Sciences, University of Oulu, Oulu
  10. 10 Diabetes Center, Finnish Diabetes Association, Tampere, Finland
  11. 11 School of Public Health and Clinical Nutrition, University of Kuopio, Finland
  12. 12 Department of Public Health, University of Helsinki, Finland
  13. 13 South Ostrobothnia Central Hospital, Seinäjoki, Finland

    Abstract

    Objective: Both short and long sleep duration have frequently been found to be associated with an increased risk for diabetes. The aim of the present exploratory analysis was to examine the association between sleep duration and type 2 diabetes after lifestyle intervention in overweight people with impaired glucose tolerance in a 7-year prospective follow-up.

    Methods: 522 individuals (aged 40-64 years) were randomly allocated either to intensive diet-exercise counseling group or control group. Diabetes incidence during follow-up was calculated according to sleep duration at baseline. Sleep duration was obtained for 24 h period. Physical activity, dietary intakes, bodyweight and immune mediators (CRP, IL-6) were measured.

    Results: Interaction between sleep duration and treatment group was statistically significant (p=0.003). In the control group, the adjusted hazard ratios with 95% CI for diabetes were 2.29 (1.38-3.80) and 2.74 (1.67-4.50) in the sleep duration groups 9-9.5 h and ≥10h, respectively, compared with that of 7-8.5 hours. In contrast, sleep duration did not influence the incidence of diabetes in the intervention group; for sleep duration groups 9-9.5 h and ≥10 h, the adjusted hazard ratios with 95% CI were 1.10 (0.60-2.01) and 0.73 (0.34-1.56), respectively, compared with that in the reference group (7-8.5 h sleep). Lifestyle intervention resulted in similar improvement in body weight, insulin sensitivity and immune mediator levels regardless of sleep duration.

    Conclusion: Long sleep duration is associated with increased type 2 diabetes risk. Lifestyle intervention aiming at weight reduction, healthy diet and increased physical activity may ameliorate some of this excess risk.

    Footnotes

      • Received November 3, 2008.
      • Accepted July 20, 2009.

    This Article

    1. Published online before print August 3, 2009, doi: 10.2337/dc08-1980
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