Associations of Sleep Timing and Regularity With Diabetes and Interactions With Diet Quality Among Adults

Late sleep timing and sleep irregularity are associated with an increased risk of diabetes, and high diet quality is associated with a lower risk of diabetes. However, the associations of sleep timing and regularity with diabetes, as well as the potential interactions of diet quality with these associations, are unclear.

The aims of the study were to examine the associations of sleep timing and sleep regularity with diabetes and to examine whether sleep timing and sleep regularity interact with diet quality in relation to diabetes.

This was a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2017-March 2020.

US adults 20 years or older who responded to questions regarding sleep health and completed at least 1 valid 24-hour diet recall were included in the analysis (n = 7270).

Diabetes was defined as having received a diagnosis of diabetes from a physician or health care professional; glycated hemoglobin ≥6.5%; fasting blood glucose ≥126 mg/dL (to convert to mmol/L, multiply by 0.0555); and taking insulin or oral medication for diabetes.

Survey-multivariable logistic regression models were used to estimate the associations of sleep timing, sleep regularity, and their interactions with diet quality and diabetes.

A total of 1494 participants (15.3%) were identified as having diabetes. Late chronotype (odds ratio [OR] 1.45; 95% CI, 1.12 to 1.87; Bonferroni corrected P = .02) and social jet lag of >0.5 hours (OR 1.44; 95% CI, 1.10 to 1.87; Bonferroni corrected P = .03) were associated with higher ORs of diabetes. Interactions were observed for diet quality with social jet lag (P for interaction = .02) on diabetes. Among participants with social jet lag of >0.5 hour, medium (OR 0.62; 95% CI, 0.41 to 0.92) and high diet quality (OR 0.63; 95% CI, 0.43 to 0.94) were associated with lower ORs of diabetes compared with low diet quality.

Later chronotype and more severe social jet lag were associated with higher ORs of diabetes. Higher diet quality may attenuate the adverse association of social jet lag with diabetes.