Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES

Background: Evidence is limited regarding the relationship between sleep factors (self-reported sleep disorder diagnosis, subjective sleep difficulties, and sleep duration), sleep patterns, and risk of type 2 diabetes mellitus (T2D). Thus, this study aims to investigate the relationship between slee...

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Main Authors: Jijun Zhang, Chuanli Yang, Jie An, Yunhe Fan, Xiushan Dong
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Brain, Behavior, & Immunity - Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666354625000110
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author Jijun Zhang
Chuanli Yang
Jie An
Yunhe Fan
Xiushan Dong
author_facet Jijun Zhang
Chuanli Yang
Jie An
Yunhe Fan
Xiushan Dong
author_sort Jijun Zhang
collection DOAJ
description Background: Evidence is limited regarding the relationship between sleep factors (self-reported sleep disorder diagnosis, subjective sleep difficulties, and sleep duration), sleep patterns, and risk of type 2 diabetes mellitus (T2D). Thus, this study aims to investigate the relationship between sleep factors, sleep patterns, and the risk of T2D using data from the National Health and Nutrition Examination Survey (NHANES). Methods: A total of 14,652 individuals aged ≥18 years from the NHANES (2005–2014) were enrolled with complete data on sleep factors, T2D, and covariates. Information on self-reported sleep disorder diagnosis, subjective sleep difficulties, and sleep duration was collected during in-home visits by trained interviewers using the Computer-Assisted Personal Interviewing system. The sleep pattern was derived from scoring three mentioned factors: no self-reported sleep disorder diagnosis, no subjective sleep difficulties, and sleep duration of 7–9 h were classified as low-risk (score 0), while the presence of self-reported sleep disorder diagnosis, subjective sleep difficulties, or sleep duration <7 or >9 h were classified as high-risk (score 1). Cumulative scores range from 0 to 3, with 0 indicating a healthy sleep pattern, 1 an intermediate sleep pattern, and 2–3 a poor sleep pattern, respectively. Weighted logistic regression was conducted to assess the association of sleep factors and sleep patterns with the risk of T2D. Results: Self-reported sleep disorder diagnosis (odds ratio (OR) = 1.32, P = 0.01), subjective sleep difficulties (OR = 1.29, P = 0.001), and sleep deprivation (<7 h; OR = 1.20, P = 0.01) were significantly positive with T2D. Poor sleep pattern also significantly increased T2D risk (OR = 1.52, P < 0.0001). Moreover, subgroup analyses stratified by age and BMI (body mass index) further confirmed that the positive association between sleep patterns and T2D was consistent and robust across groups. Conclusion: Our findings indicate that poorer sleep patterns are associated with an increased risk of T2D. These results emphasize the importance of sleep management in T2D prevention. Further prospective studies are needed to investigate the causal or bidirectional relationship between sleep and T2D risk, as well as the underlying molecular mechanisms.
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spelling doaj-art-a70d0436d96f426f910fad6bd6ffdfee2025-08-20T02:58:53ZengElsevierBrain, Behavior, & Immunity - Health2666-35462025-03-014410095310.1016/j.bbih.2025.100953Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANESJijun Zhang0Chuanli Yang1Jie An2Yunhe Fan3Xiushan Dong4Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, ChinaKey Laboratory of Environmental Medical Engineering and Education Ministry, School of Public Health, Southeast University, Nanjing, Jiangsu, China; Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, ChinaDepartment of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, ChinaDepartment of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, ChinaThird Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China; Corresponding author. Address: No.99 Longcheng Street, Shanxi Bethune Hospital, China.Background: Evidence is limited regarding the relationship between sleep factors (self-reported sleep disorder diagnosis, subjective sleep difficulties, and sleep duration), sleep patterns, and risk of type 2 diabetes mellitus (T2D). Thus, this study aims to investigate the relationship between sleep factors, sleep patterns, and the risk of T2D using data from the National Health and Nutrition Examination Survey (NHANES). Methods: A total of 14,652 individuals aged ≥18 years from the NHANES (2005–2014) were enrolled with complete data on sleep factors, T2D, and covariates. Information on self-reported sleep disorder diagnosis, subjective sleep difficulties, and sleep duration was collected during in-home visits by trained interviewers using the Computer-Assisted Personal Interviewing system. The sleep pattern was derived from scoring three mentioned factors: no self-reported sleep disorder diagnosis, no subjective sleep difficulties, and sleep duration of 7–9 h were classified as low-risk (score 0), while the presence of self-reported sleep disorder diagnosis, subjective sleep difficulties, or sleep duration <7 or >9 h were classified as high-risk (score 1). Cumulative scores range from 0 to 3, with 0 indicating a healthy sleep pattern, 1 an intermediate sleep pattern, and 2–3 a poor sleep pattern, respectively. Weighted logistic regression was conducted to assess the association of sleep factors and sleep patterns with the risk of T2D. Results: Self-reported sleep disorder diagnosis (odds ratio (OR) = 1.32, P = 0.01), subjective sleep difficulties (OR = 1.29, P = 0.001), and sleep deprivation (<7 h; OR = 1.20, P = 0.01) were significantly positive with T2D. Poor sleep pattern also significantly increased T2D risk (OR = 1.52, P < 0.0001). Moreover, subgroup analyses stratified by age and BMI (body mass index) further confirmed that the positive association between sleep patterns and T2D was consistent and robust across groups. Conclusion: Our findings indicate that poorer sleep patterns are associated with an increased risk of T2D. These results emphasize the importance of sleep management in T2D prevention. Further prospective studies are needed to investigate the causal or bidirectional relationship between sleep and T2D risk, as well as the underlying molecular mechanisms.http://www.sciencedirect.com/science/article/pii/S2666354625000110Type 2 diabetes mellitusSelf-reported sleep disorder diagnosisSubjective sleep difficultiesSleep durationSleep patternsNHANES
spellingShingle Jijun Zhang
Chuanli Yang
Jie An
Yunhe Fan
Xiushan Dong
Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
Brain, Behavior, & Immunity - Health
Type 2 diabetes mellitus
Self-reported sleep disorder diagnosis
Subjective sleep difficulties
Sleep duration
Sleep patterns
NHANES
title Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
title_full Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
title_fullStr Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
title_full_unstemmed Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
title_short Evaluating sleep's role in type 2 diabetes mellitus: Evidence from NHANES
title_sort evaluating sleep s role in type 2 diabetes mellitus evidence from nhanes
topic Type 2 diabetes mellitus
Self-reported sleep disorder diagnosis
Subjective sleep difficulties
Sleep duration
Sleep patterns
NHANES
url http://www.sciencedirect.com/science/article/pii/S2666354625000110
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AT yunhefan evaluatingsleepsroleintype2diabetesmellitusevidencefromnhanes
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