Sleep disturbances and glucose metabolism in older adults

The cardiovascular health study

Linn Beate Strand, Mercedes Carnethon, Mary Lou Biggs, Luc Djousś E, Robert C. Kaplan, David S. Siscovick, John A. Robbins, Susan Redline, Sanjay R. Patel, Imre Janszky, Kenneth J. Mukamal

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported SDB and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, fromwhich insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. We determined the cross-sectional associations of sleep symptoms with fasting glucose levels, 2-h glucose levels, insulin sensitivity, and insulin secretion using generalized estimated equations and linear regression models. We determined the associations of updated and averaged sleep symptoms with incident diabetes in Cox proportional hazards models. We adjusted for sociodemographics, lifestyle factors, and medical history. RESULTS Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher 2-h glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea (hazard ratio [HR] 1.84 [95% CI 1.19- 2.86]), snoring (HR 1.27 [95% CI 0.95-1.71]), and daytime sleepiness (HR 1.54 [95% CI 1.13-2.12]). In contrast, we did not find consistent associations between insomnia symptoms and glucose metabolism or incident type 2 diabetes. CONCLUSIONS Easily collected symptoms of SDB are strongly associated with insulin resistance and the incidence of type 2 diabetes in older adults. Monitoring glucose metabolism in such patients may prove useful in identifying candidates for lifestyle or pharmacological therapy. Further studies are needed to determine whether insomnia symptoms affect the risk of diabetes in younger adults.

Original languageEnglish (US)
Pages (from-to)2050-2058
Number of pages9
JournalDiabetes Care
Volume38
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Sleep
Glucose
Health
Sleep Initiation and Maintenance Disorders
Snoring
Type 2 Diabetes Mellitus
Insulin Resistance
Sleep Apnea Syndromes
Fasting
Apnea
Insulin
Life Style
Linear Models
Glucose Tolerance Test
Proportional Hazards Models
Young Adult
Respiration
Pharmacology
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Strand, L. B., Carnethon, M., Biggs, M. L., E, L. D., Kaplan, R. C., Siscovick, D. S., ... Mukamal, K. J. (2015). Sleep disturbances and glucose metabolism in older adults: The cardiovascular health study. Diabetes Care, 38(11), 2050-2058. https://doi.org/10.2337/dc15-0137

Sleep disturbances and glucose metabolism in older adults : The cardiovascular health study. / Strand, Linn Beate; Carnethon, Mercedes; Biggs, Mary Lou; E, Luc Djousś; Kaplan, Robert C.; Siscovick, David S.; Robbins, John A.; Redline, Susan; Patel, Sanjay R.; Janszky, Imre; Mukamal, Kenneth J.

In: Diabetes Care, Vol. 38, No. 11, 01.11.2015, p. 2050-2058.

Research output: Contribution to journalArticle

Strand, LB, Carnethon, M, Biggs, ML, E, LD, Kaplan, RC, Siscovick, DS, Robbins, JA, Redline, S, Patel, SR, Janszky, I & Mukamal, KJ 2015, 'Sleep disturbances and glucose metabolism in older adults: The cardiovascular health study', Diabetes Care, vol. 38, no. 11, pp. 2050-2058. https://doi.org/10.2337/dc15-0137
Strand, Linn Beate ; Carnethon, Mercedes ; Biggs, Mary Lou ; E, Luc Djousś ; Kaplan, Robert C. ; Siscovick, David S. ; Robbins, John A. ; Redline, Susan ; Patel, Sanjay R. ; Janszky, Imre ; Mukamal, Kenneth J. / Sleep disturbances and glucose metabolism in older adults : The cardiovascular health study. In: Diabetes Care. 2015 ; Vol. 38, No. 11. pp. 2050-2058.
@article{cf077bd50c4a4f538b0b122f8eb2b17a,
title = "Sleep disturbances and glucose metabolism in older adults: The cardiovascular health study",
abstract = "OBJECTIVE We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported SDB and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, fromwhich insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. We determined the cross-sectional associations of sleep symptoms with fasting glucose levels, 2-h glucose levels, insulin sensitivity, and insulin secretion using generalized estimated equations and linear regression models. We determined the associations of updated and averaged sleep symptoms with incident diabetes in Cox proportional hazards models. We adjusted for sociodemographics, lifestyle factors, and medical history. RESULTS Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher 2-h glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea (hazard ratio [HR] 1.84 [95{\%} CI 1.19- 2.86]), snoring (HR 1.27 [95{\%} CI 0.95-1.71]), and daytime sleepiness (HR 1.54 [95{\%} CI 1.13-2.12]). In contrast, we did not find consistent associations between insomnia symptoms and glucose metabolism or incident type 2 diabetes. CONCLUSIONS Easily collected symptoms of SDB are strongly associated with insulin resistance and the incidence of type 2 diabetes in older adults. Monitoring glucose metabolism in such patients may prove useful in identifying candidates for lifestyle or pharmacological therapy. Further studies are needed to determine whether insomnia symptoms affect the risk of diabetes in younger adults.",
author = "Strand, {Linn Beate} and Mercedes Carnethon and Biggs, {Mary Lou} and E, {Luc Djousś} and Kaplan, {Robert C.} and Siscovick, {David S.} and Robbins, {John A.} and Susan Redline and Patel, {Sanjay R.} and Imre Janszky and Mukamal, {Kenneth J.}",
year = "2015",
month = "11",
day = "1",
doi = "10.2337/dc15-0137",
language = "English (US)",
volume = "38",
pages = "2050--2058",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

TY - JOUR

T1 - Sleep disturbances and glucose metabolism in older adults

T2 - The cardiovascular health study

AU - Strand, Linn Beate

AU - Carnethon, Mercedes

AU - Biggs, Mary Lou

AU - E, Luc Djousś

AU - Kaplan, Robert C.

AU - Siscovick, David S.

AU - Robbins, John A.

AU - Redline, Susan

AU - Patel, Sanjay R.

AU - Janszky, Imre

AU - Mukamal, Kenneth J.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - OBJECTIVE We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported SDB and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, fromwhich insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. We determined the cross-sectional associations of sleep symptoms with fasting glucose levels, 2-h glucose levels, insulin sensitivity, and insulin secretion using generalized estimated equations and linear regression models. We determined the associations of updated and averaged sleep symptoms with incident diabetes in Cox proportional hazards models. We adjusted for sociodemographics, lifestyle factors, and medical history. RESULTS Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher 2-h glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea (hazard ratio [HR] 1.84 [95% CI 1.19- 2.86]), snoring (HR 1.27 [95% CI 0.95-1.71]), and daytime sleepiness (HR 1.54 [95% CI 1.13-2.12]). In contrast, we did not find consistent associations between insomnia symptoms and glucose metabolism or incident type 2 diabetes. CONCLUSIONS Easily collected symptoms of SDB are strongly associated with insulin resistance and the incidence of type 2 diabetes in older adults. Monitoring glucose metabolism in such patients may prove useful in identifying candidates for lifestyle or pharmacological therapy. Further studies are needed to determine whether insomnia symptoms affect the risk of diabetes in younger adults.

AB - OBJECTIVE We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported SDB and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, fromwhich insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. We determined the cross-sectional associations of sleep symptoms with fasting glucose levels, 2-h glucose levels, insulin sensitivity, and insulin secretion using generalized estimated equations and linear regression models. We determined the associations of updated and averaged sleep symptoms with incident diabetes in Cox proportional hazards models. We adjusted for sociodemographics, lifestyle factors, and medical history. RESULTS Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher 2-h glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea (hazard ratio [HR] 1.84 [95% CI 1.19- 2.86]), snoring (HR 1.27 [95% CI 0.95-1.71]), and daytime sleepiness (HR 1.54 [95% CI 1.13-2.12]). In contrast, we did not find consistent associations between insomnia symptoms and glucose metabolism or incident type 2 diabetes. CONCLUSIONS Easily collected symptoms of SDB are strongly associated with insulin resistance and the incidence of type 2 diabetes in older adults. Monitoring glucose metabolism in such patients may prove useful in identifying candidates for lifestyle or pharmacological therapy. Further studies are needed to determine whether insomnia symptoms affect the risk of diabetes in younger adults.

UR - http://www.scopus.com/inward/record.url?scp=84962362087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962362087&partnerID=8YFLogxK

U2 - 10.2337/dc15-0137

DO - 10.2337/dc15-0137

M3 - Article

VL - 38

SP - 2050

EP - 2058

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -