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TOPLINE:

Insufficient sleep duration and late sleep onset, alone or in combination, were associated with increased glycemic variability in middle-aged and older adults.

METHODOLOGY:

• Suboptimal sleep, including inadequate length and late timing, impairs glucose metabolism. Understanding this interplay could inform preventive strategies for diabetes and related metabolic diseases.
• Researchers investigated the association of long-term sleep duration and onset timing with glycemic dynamics using regression models in 1156 middle-aged and older adult participants (mean age, 63.0 years at baseline; 70.6% women) from a prospective cohort in Guangdong, China.
• Participants wore a masked continuous glucose monitoring device for 14 consecutive days, recording interstitial glucose levels every 15 minutes, to assess glycemic variability and control.
• Glycemic variability was assessed using measures such as coefficient of variation (CV), mean amplitude of glycemic excursions, mean of daily differences, and standard deviation (SD). Time in range and mean blood glucose levels were used as indices of current glycemic control.
• Self-reported sleep duration per night (categorized as severely [4.7-4.1 hours], moderately [6.0-5.5 hours], or mildly [7.2-6.8 hours] inadequate or adequate [8.4-8.0 hours]) and onset timing (persistently early or late onset) were assessed at baseline (2013-2017) and two follow-up points (2017-2021 and 2021-2023) on the basis of past month’s patterns.

TAKEAWAY:

• Compared with adequate sleep duration, severe inadequate sleep duration was associated with a 2.87% increase in CV for glycemic variability (95% CI, 1.23%-4.50%), higher SD (β, 0.17 mmol/L; 95% CI, 0.05-0.30 mmol/L), mean amplitude of glycemic excursions (β, 0.47 mmol/L; 95% CI, 0.12-0.82 mmol/L), and mean of daily differences (β, 0.06 mmol/L; 95% CI, 0.02-0.09 mmol/L).
• Time in range was lower in the severe inadequate sleep duration group than in the adequate sleep duration group (β, −3.11%; 95% CI, −5.42% to −0.80%).
• The persistently late sleep onset was significantly associated with greater glycemic variability, as evidenced by increases in CV (β, 1.18%; P = .01), SD (β, 0.08 mmol/L; P = .02), and mean of daily differences (β, 0.02 mmol/L; P = .01) in an adjusted model.
• Combined inadequate sleep duration and late sleep onset was associated with elevated glycemic variability compared with combined adequate sleep duration and early sleep onset, with increased CV, SD, mean amplitude of glycemic excursions, and mean of daily differences.

IN PRACTICE:

“Our findings emphasize the potential detrimental role of circadian rhythm misalignment on glycemic regulation, providing evidence to incorporate sleep timing into glucose management guidelines,” the authors wrote. “[The study] findings underscore the importance of ensuring sufficient sleep duration and adhering to an early sleep onset to optimize glycemic control and mitigate related health complications,” they added.

SOURCE:

This study was led by Luqi Shen, PhD, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, and Bang-yan Li, MS, School of Public Health, Sun Yat-sen University, Guangzhou, China. It was published online in JAMA Network Open.

LIMITATIONS:

This study relied on self-reported sleep patterns instead of objective measurements. The lack of thorough examination of factors such as sleep apnea could have introduced bias. Limited measurements for trajectory groups may have missed detailed chronic sleep fluctuations. The sample was restricted to middle-aged and older Chinese individuals, limiting generalizability of the findings to other populations.

DISCLOSURES:

This study was funded by grants from the Zhejiang Provincial Natural Science Foundation of China, Pioneer and Leading Goose Research and Development Program of Zhejiang, National Key Research and Development Program of China, National Natural Science Foundation of China, and Research Program of Westlake Laboratory of Life Sciences and Biomedicine. The authors did not disclose any relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.