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Association Between Sleep Duration and Glycemic Levels in Adults With Prediabetes: A Population-based Study
Zhongqing Mou1, Yan Zhou2, Zaiquan Dong3
1Department of Endocrinology, Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.
Objective:
Sleep duration is increasingly recognized as a modifiable risk factor for diabetes. Evidence specific to adults with prediabetes, a critical period for diabetes prevention, remains limited. This study aimed to investigate the association between sleep duration and glycemic levels in a nationally representative sample of adults with prediabetes.
Methods:
A total of 1,090 participants with prediabetes were included from the 2017-2020 National Health and Nutrition Examination Survey. Prediabetes was defined by a fasting plasma glucose (FPG) level of 5.6 to <7.0 mmol/L or a glycated hemoglobin (HbA1C) level of 5.7 to <6.5% without diagnosed diabetes. Sleep duration was calculated using weekday and weekend sleep hours. Survey-weighted multiple linear regression and smooth curve fitting were applied to evaluate the linear and nonlinear associations between sleep duration and glycemic levels (FPG and HbA1C). Threshold effects were evaluated using a 2-piecewise linear regression model, and subgroup analyses were performed.
Results:
Multiple linear regression analysis demonstrated a nonlinear association between sleep duration and FPG levels, with an inflection point at 6 hours per night. Below this threshold, each additional hour of sleep was associated with a lower FPG level (beta = -0.126, 95% confidence interval: -0.194 to -0.058; p=0.0003). No significant association was observed between sleep duration and FPG levels above 6 hours or between sleep duration and HbA1C levels in the fully adjusted model. Subgroup analyses indicated that associations differed by sex and race/ethnicity, with significant inverse associations observed in men and among Mexican American adults.
Conclusions:
Short sleep duration (<6 hours per night) was independently associated with elevated FPG levels in adults with prediabetes. These findings indicate that improving sleep duration may be a potentially modifiable factor for glycemic management in populations with prediabetes.
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