The association between sleep efficiency and diabetes mellitus in community-dwelling individuals with or without sleep-disordered breathing

Abstract

Background: Sleeping habits have been reported to be associated with diabetes mellitus. This study aimed to explore the relationship of sleep efficiency with diabetes mellitus in individuals with or without sleep-disordered breathing based on polysomnography records.

Methods: We enrolled participants from the Sleep Heart Health Study. Objective indicators of sleep characteristics including sleep efficiency, sleep latency, slow-wave sleep, wake after sleep onset, and total arousal index were monitored via in-home polysomnography. Sleep efficiency was divided into grade 1 (≥85%), grade 2 (80%-84.9%), and grade 3 (<80%). Multivariate logistic regression models were utilized to investigate the association between sleep quality and diabetes mellitus.

Results: The present study comprised 4737 participants with a mean age of 63.6 ± 11.0 years. The prevalence of diabetes mellitus was higher in those with grade 3 sleep efficiency than that in those with grade 1 and grade 2 sleep efficiency in participants with (10.9% vs 8.5% vs 8.3%, respectively; P =.134) or without (9.5% vs 5.6% vs 3.5%, respectively; P <.001) sleep-disordered breathing. After adjusting for potential confounding factors, sleep efficiency <80% was associated with the prevalence of diabetes mellitus only in participants without sleep-disordered breathing (odds ratio, 1.894; 95% confidence interval, 1.187-3.022, P =.007).

Conclusion: Poor sleep efficiency is associated with diabetes mellitus in those without sleep-disordered breathing. Therefore, the relationship between sleep efficiency and diabetes mellitus is worth further investigation.

Keywords: SHHS; diabetes mellitus; polysomnography; sleep efficiency; sleep-disordered breathing; 睡眠呼吸暂停; 睡眠多导图; 睡眠心脏健康研究; 睡眠效率; 糖尿病.