Taiwan Study on Sleep Duration and Mortality in T2D Patients

A recent study in the journal Cardiovascular Diabetology has revealed a J-shaped association between increased all-cause and expanded CVD mortalities and sleep durations in type 2 diabetes (T2D) patients. Further, sleep duration of 5-7 hours per day had the lowest risk of mortality.

The risk of all-cause and expanded CVD mortalities were seen to be higher in patients who sleep for less or more than 7 hours per night and with age ≥ 65 years, diabetes duration ≥ 5 years, insulin use, diabetes diagnosis ≤ 45 years, SBP/DBP > 130/85 mmHg, HbA1c ≥ 7%, and TG ≥ 150 mg/dL than in those with 7 hours of sleep and their counterparts.

Sleep duration is associated with mortality. However, previous studies that explored whether sleep duration predicts subsequent long-term mortality in patients with diabetes are limited. To fill this knowledge gap, Tsai-Chung Li, Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan, and colleagues aimed to investigate whether metabolic factors affect the associations between baseline sleep duration and subsequent risks of all-cause, expanded, and non-expanded cardiovascular disease (CVD) mortalities among type 2 diabetes patients.

For this purpose, the researchers identified a total of 12,526 T2D patients aged 30 years and older from the Diabetes Case Management Program of a medical center in Taiwan, with a follow-up period ≥ 3 years. Computerized questionnaires by case managers were used to measure sleep duration, and the time frame for this question was 1 month prior to the interview date. Cox proportional hazard models were used to examine sleep duration in relation to subsequent mortality from all causes, expanded CVD, and non-expanded CVD.

Key Findings of the Study

• Within 10 years of follow-up, 2918 deaths (1328 CVD deaths and 1590 non-CVD deaths) were recorded.
• A J-shaped association was observed for all-cause, expanded CVD, and non-expanded CVD mortalities, and the lowest risks were observed for patients with 5–7 hours of sleep.
• The significant joint effects included sleep duration of more or less than 7 hours with:
  • Age ≥ 65 years [adjusted HRs: 4.00]
  • Diabetes duration ≥ 5 years [1.60]
  • Age at diabetes diagnosis ≤ 45 years [1.69]
  • Insulin use [1.76]
  • Systolic blood pressure/diastolic blood pressure > 130/85 mmHg [1.24]
  • Triglyceride ≥ 150 mg/dL [1.38]
  • HbA1c ≥ 7% [1.31]
  • Body mass index < 27 kg/m² [1.31] for all-cause mortality.

To conclude, the researchers found a J-shaped association with increased all-cause and expanded CVD mortalities for sleep durations in people with T2D.

Reference

Li, CI., Lin, CC., Liu, CS. et al. Sleep duration predicts subsequent long-term mortality in patients with type 2 diabetes: a large single-center cohort study. Cardiovasc Diabetol 21, 60 (2022). https://doi.org/10.1186/s12933-022-01500-0