Aug 2026· European Journal of Medical Research· 0 citations
TL;DR
Sleep disorders and abnormal sleep duration were associated with diabetic kidney disease among Americans aged 45 and older, and sleep-related factors may warrant consideration in the comprehensive clinical assessment of individuals with diabetes.
Abstract
Diabetic kidney disease (DKD) is a frequent microvascular manifestation of diabetes. However, the associations between sleep disorders, sleep duration time (SDT), and DKD remain inadequately understood. This study seeks to examine the associations of sleep-related factors with the prevalence of DKD among Americans aged 45 and older.
A cross-sectional analysis was carried out utilizing the 2007–2014 National Health and Nutrition Examination Survey (NHANES) data. Four sleep-related variables were evaluated: continuous SDT, categorized SDT, self-reported sleep disorders, and clinically diagnosed sleep disorders. The associations of sleep-related factors with DKD were examined via weighted logistic regression models and subgroup analyses, with adjustments for multiple potential confounders. Possible nonlinear associations between SDT and DKD were explored using restricted cubic spline (RCS) functions. Propensity score matching (PSM) was applied to evaluate the robustness of the findings.
10,780 participants were included. The overall DKD prevalence was 11.5% (n = 1243). Both self-reported sleep disorders (Model 3: OR = 1.43, 95% CI 1.16–1.77, P < 0.05) and clinically diagnosed sleep disorders (Model 3: odds ratio (OR) = 1.56, 95% confidence interval (CI) 1.15–2.11, P < 0.05) were associated with a higher prevalence of DKD. Prolonged SDT (> 9 h) was also associated with a higher DKD prevalence (OR = 1.63, 95% CI 1.08–2.46, P < 0.05). RCS analysis demonstrated a U-shaped association between SDT and DKD (P for overall association = 0.001; P for nonlinearity < 0.001).
In this cross-sectional analysis, sleep disorders and abnormal sleep duration were associated with DKD. Sleep-related factors may warrant consideration in the comprehensive clinical assessment of individuals with diabetes. Longitudinal studies are required to clarify temporal relationships.
ABSTRACT Aims To prospectively examine how combined sleep behaviors affect vascular complications in type 2 diabetes, whether these associations are modified by disease severity, as well as the mediating roles of clinical biomarkers. Methods A total of 12,456 participants with type 2 diabetes from the UK Biobank were included. A sleep score was defined by: sleep duration, chronotype, insomnia, snoring, and daytime sleepiness. Cox regression models were used to examine the association between healthy sleep score and risk of vascular complications. Results Over 13.5 years, 1,878 macrovascular and 3,066 microvascular complications occurred. Compared with a healthy sleep score of 0–1, the multivariable‐adjusted HRs (95% CIs) of the score 4–5 were 0.75 (0.63, 0.89) for macrovascular complications [coronary artery disease 0.72 (0.57, 0.91), stroke 0.92 (0.66, 1.28), peripheral artery disease 0.79 (0.56, 1.10)]; 0.86 (0.75, 0.99) for microvascular complications [neuropathy 0.62 (0.47, 0.83), nephropathy 1.01 (0.84, 1.21), retinopathy 0.84 (0.68, 1.03)]. The aggregated diabetes severity score (P interaction = 0.037) significantly modified the association with microvascular complications. Total cholesterol, LDL‐C, triglycerides, apolipoprotein B, and CRP collectively explained 11.34% (4.24%, 37.70%) of macrovascular associations [including 11.14% (2.85%, 43.03%) for coronary artery disease], while total bilirubin explained 3.57% (0.43%, 20.63%) of microvascular associations, collectively with triglycerides, GGT, and CRP mediating 9.33% (3.95%, 27.58%) for diabetic neuropathy. Conclusions A healthy sleep pattern is associated with lower risks of vascular complications in type 2 diabetes, independent of traditional risk factors, and the association with microvascular complications is modified by diabetes severity. Lipid profiles and inflammatory factors partly mediate the favorable association.
Yanqiu Zou, Xia Jiang, Jinyu Zhou et al.· Journal of Diabetes Investig...· 0 citations
Objective: This study aimed to assess the prevalence and patterns of sleep disorders among older adults in India and examine the influence of depression, functional status (ADL and IADL) and physical activity on sleep health.
Methods: A secondary analysis of the 2017-2018 Longitudinal Ageing Study in India (LASI) was conducted among adults aged ≥60 years with complete sleep-related data. Sleep disorder was defined as self-reported frequent sleep disturbances. Weighted prevalence estimates and multivariable logistic regression accounting for complex survey design were used to identify sociodemographic, behavioural and health-related determinants. Results are presented as Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs).
Results: The prevalence of frequent sleep disorder among older adults was 0.95% as per the symptom-based definition. However, a substantially larger proportion reported occasional sleep disturbances, indicating a broader burden of sleep-related complaints. In adjusted analysis, depression emerged as a strong independent predictor of sleep disorder. Older adults with depressive symptoms had higher odds of reporting a sleep disorder compared to those without depression. Multimorbidity (2 or more chronic conditions) was also truly associated with increased odds of sleep disorder. Physical inactivity was identified as an additional modifiable risk factor. Sociodemographic factors such as age, sex and marital status were not associated with sleep disorders after adjusting for health-related variables.
Conclusion: Despite low prevalence under the LASI definition, sleep disorders remain important among older Indians. Mental health, chronic diseases and lifestyle factors outweigh demographics, highlighting the need for integrated sleep, mental health and geriatric care.
Satyabrata Pradhan, Rachita Pradhan, Sushmita Kerketta et al.· Journal of Clinical Medicine...· 0 citations
It is found that changes in sleep duration were linked to gastrointestinal diseases, with depression playing a mediating role, which suggests that changes in sleep duration and mental health may help to prevent gastrointestinal disturbances.
Jian-hao Zheng, Lingyan Qiu, D. Shi et al.· Medicine· 0 citations
PurposeTo examine the association between sleep duration and metabolic syndrome (MetS) prevalence in U.S. adults.DesignCross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data.SettingUnited States.Sample14 982 adults (≥18 years) from 7 NHANES cycles (2005-2020) with complete data on sleep, MetS components, and covariates.MeasuresSelf-reported sleep duration (short: <7 h, normal: 7-9 h, long: >9 h). MetS was defined by NCEP ATP III criteria. Covariates included age, sex, race/ethnicity, sedentary time, and smoking.AnalysisSurvey-weighted logistic regression modeled sleep as continuous linear and quadratic terms. Sensitivity analyses included restricted cubic splines and component-wise assessment.ResultsA U-shaped association was observed between sleep duration and MetS. Compared with normal sleep, both short (<7 h) and long (>9 h) sleep were associated with higher odds of MetS in fully adjusted models. Linear (OR = 0.68, 95% CI: 0.56-0.82) and quadratic (OR = 1.03, 95% CI: 1.01-1.04) terms confirmed nonlinearity (P < 0.001). The model-derived sleep duration associated with the lowest predicted odds of MetS was 7.52 h/night (95% CI: 6.81-8.24 h). Age, sedentary time, and smoking independently increased MetS risk. The U-shaped pattern persisted across most individual MetS components and was supported by spline analyses.ConclusionBoth short and long sleep durations were significantly associated with higher odds of metabolic syndrome, highlighting sleep duration as a potential indicator for cardiometabolic risk screening.
Hafiz M. Ahmed, Abdullah Dar, M. Owais et al.· American Journal of Health P...· 0 citations
Objective To delve into the intricate relationship between sleep quality and prevalence of type 2 diabetes (T2D) among community-dwelling chronic disease patients, and to provide insights that can inform clinical practice. Methods Data on basic information and sleep quality of patients with chronic diseases were collected via questionnaire surveys. Following descriptive and logistic regression analyses, restricted cubic spline regression was further applied to explore a possible nonlinear dose-response relationship between sleep quality and prevalence of T2D among these patients. Results A total of 902 valid samples were included in this study, among which 565 were cases of T2D, accounting for 62.64%. The average score of the Pittsburgh Sleep Quality Index (PSQI) was 11.11. In all three models, a positive association was observed between higher PSQI scores and prevalence of T2D. Subsequent analysis employing RCS regression substantiates this nonlinear association and discerns two inflection points at 12 and 13 When the PSQI score was greater than 12, the odds ratio (OR) increased with higher PSQI scores, suggesting a significant increase in the association with the prevalence of T2D. When the PSQI score reaches 13, the OR stabilises, indicating that the rate of increase in risk has slowed. Conclusion Sleep quality is an important factor for the prevalence of T2D, exhibiting a threshold range effect. Community health practitioners may consider sleep quality assessment as a supplementary tool, particularly in patients with existing chronic conditions. Implementing targeted sleep improvement interventions in this high-risk subgroup (PSQI≥12) may holds substantial potential to be associated with reduced T2D prevalence.
Juan Ge, Peifang Lu, Shuzhi Peng et al.· PLoS ONE· 0 citations
Diabetic retinopathy (DR) significantly impairs patients’ psychological well-being and quality of life, yet the association between DR and suicidal ideation (SI) remains unclear. This study investigates this potential association and its consistency across various population subgroups. We performed a cross-sectional analysis using data from 7 cycles (2005–2006 through 2017–2018) of the National Health and Nutrition Examination Survey. The final analytical sample comprised 4006 adults with diabetes. Weighted multivariate regression analysis was used to assess the association between DR and SI. Subgroup analyses, interaction analyses, and a series of sensitivity analyses were used to explore the stability of the results. After sequential adjustment for demographic characteristics, lifestyle factors, comorbidities, and depressive symptoms, DR was associated with an increased risk for SI (odds ratio = 1.70, 95% confidence interval: 1.08–2.68, P = .023). Subgroup analyses showed generally consistent positive associations across most subgroups, and no significant interaction remained after correction for multiple comparisons. Sensitivity analyses confirmed robustness (multiple imputation and diabetes-related adjustment remained significant). In a sensitivity analysis using a fundus photography-based DR definition (limited to 2005–2008 cycles with a small sample size and few SI events), the estimate was nonsignificant but directionally consistent (odds ratio = 1.27; P = .607). DR is associated with increased SI among United States diabetic adults, independent of depressive symptoms. Given the cross-sectional design, these findings should be interpreted cautiously and confirmed in future prospective studies.
Najuan Huang, Yaru Du, Yan Zheng et al.· Medicine· 0 citations
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