Joint associations of insomnia and sleep duration with prevalent diabetes

The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Elizabeth M. Cespedes, Katherine A. Dudley, Daniela Sotres-Alvarez, Phyllis C. Zee, Martha L. Daviglus, Neomi A. Shah, Gregory A. Talavera, Linda C. Gallo, Josiemer Mattei, Qibin Qi, Alberto R. Ramos, Neil Schneiderman, Rebeca A. Espinoza-Giacinto, Sanjay R. Patel

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in US Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse US Hispanic/Latinos. Methods: Baseline data on sleep quantity and quality were obtained from 15227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6h, average >6-9h, long >9h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea. Results: In the weighted population, 14% had diabetes, 28% had insomnia, 9% were short sleepers, and 19% were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95% CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95% CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia. Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.

Original languageEnglish (US)
JournalJournal of Diabetes
DOIs
StateAccepted/In press - 2015

Fingerprint

Sleep Initiation and Maintenance Disorders
Hispanic Americans
Sleep
Health
Sleep Apnea Syndromes
Confidence Intervals
Type 2 Diabetes Mellitus
Body Mass Index
Obesity
Cross-Sectional Studies
Logistic Models
Odds Ratio
Exercise
Diet
Phenotype
Education

Keywords

  • Acculturation
  • Hispanic Americans
  • Insomnia
  • Sleep
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Cespedes, E. M., Dudley, K. A., Sotres-Alvarez, D., Zee, P. C., Daviglus, M. L., Shah, N. A., ... Patel, S. R. (Accepted/In press). Joint associations of insomnia and sleep duration with prevalent diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Journal of Diabetes. https://doi.org/10.1111/1753-0407.12308

Joint associations of insomnia and sleep duration with prevalent diabetes : The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). / Cespedes, Elizabeth M.; Dudley, Katherine A.; Sotres-Alvarez, Daniela; Zee, Phyllis C.; Daviglus, Martha L.; Shah, Neomi A.; Talavera, Gregory A.; Gallo, Linda C.; Mattei, Josiemer; Qi, Qibin; Ramos, Alberto R.; Schneiderman, Neil; Espinoza-Giacinto, Rebeca A.; Patel, Sanjay R.

In: Journal of Diabetes, 2015.

Research output: Contribution to journalArticle

Cespedes, EM, Dudley, KA, Sotres-Alvarez, D, Zee, PC, Daviglus, ML, Shah, NA, Talavera, GA, Gallo, LC, Mattei, J, Qi, Q, Ramos, AR, Schneiderman, N, Espinoza-Giacinto, RA & Patel, SR 2015, 'Joint associations of insomnia and sleep duration with prevalent diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)', Journal of Diabetes. https://doi.org/10.1111/1753-0407.12308
Cespedes, Elizabeth M. ; Dudley, Katherine A. ; Sotres-Alvarez, Daniela ; Zee, Phyllis C. ; Daviglus, Martha L. ; Shah, Neomi A. ; Talavera, Gregory A. ; Gallo, Linda C. ; Mattei, Josiemer ; Qi, Qibin ; Ramos, Alberto R. ; Schneiderman, Neil ; Espinoza-Giacinto, Rebeca A. ; Patel, Sanjay R. / Joint associations of insomnia and sleep duration with prevalent diabetes : The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). In: Journal of Diabetes. 2015.
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abstract = "Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in US Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse US Hispanic/Latinos. Methods: Baseline data on sleep quantity and quality were obtained from 15227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6h, average >6-9h, long >9h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea. Results: In the weighted population, 14{\%} had diabetes, 28{\%} had insomnia, 9{\%} were short sleepers, and 19{\%} were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95{\%} confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95{\%} CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95{\%} CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia. Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.",
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T1 - Joint associations of insomnia and sleep duration with prevalent diabetes

T2 - The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

AU - Cespedes, Elizabeth M.

AU - Dudley, Katherine A.

AU - Sotres-Alvarez, Daniela

AU - Zee, Phyllis C.

AU - Daviglus, Martha L.

AU - Shah, Neomi A.

AU - Talavera, Gregory A.

AU - Gallo, Linda C.

AU - Mattei, Josiemer

AU - Qi, Qibin

AU - Ramos, Alberto R.

AU - Schneiderman, Neil

AU - Espinoza-Giacinto, Rebeca A.

AU - Patel, Sanjay R.

PY - 2015

Y1 - 2015

N2 - Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in US Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse US Hispanic/Latinos. Methods: Baseline data on sleep quantity and quality were obtained from 15227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6h, average >6-9h, long >9h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea. Results: In the weighted population, 14% had diabetes, 28% had insomnia, 9% were short sleepers, and 19% were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95% CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95% CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia. Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.

AB - Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in US Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse US Hispanic/Latinos. Methods: Baseline data on sleep quantity and quality were obtained from 15227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6h, average >6-9h, long >9h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea. Results: In the weighted population, 14% had diabetes, 28% had insomnia, 9% were short sleepers, and 19% were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95% CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95% CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia. Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.

KW - Acculturation

KW - Hispanic Americans

KW - Insomnia

KW - Sleep

KW - Type 2 diabetes mellitus

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