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Cross-sectional and prospective associations between sleep regularity and metabolic health in the Hispanic Community Health Study/Study of Latinos.

  • Fritz, Josef1
  • Phillips, Andrew J K2
  • Hunt, Larissa C1
  • Imam, Akram1
  • Reid, Kathryn J3
  • Perreira, Krista M4
  • Mossavar-Rahmani, Yasmin5
  • Daviglus, Martha L6
  • Sotres-Alvarez, Daniela7
  • Zee, Phyllis C3
  • Patel, Sanjay R8
  • Vetter, Céline1
  • 1 Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO.
  • 2 Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia. , (Australia)
  • 3 Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Chicago, IL.
  • 4 Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.
  • 5 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
  • 6 College of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL.
  • 7 Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • 8 Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, PA.
Published Article
Oxford University Press
Publication Date
Apr 09, 2021
DOI: 10.1093/sleep/zsaa218
PMID: 33095850


Sleep is an emergent, multi-dimensional risk factor for diabetes. Sleep duration, timing, quality, and insomnia have been associated with diabetes risk and glycemic biomarkers, but the role of sleep regularity in the development of metabolic disorders is less clear. We analyzed data from 2107 adults, aged 19-64 years, from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos, followed over a mean of 5.7 years. Multivariable-adjusted complex survey regression methods were used to model cross-sectional and prospective associations between the sleep regularity index (SRI) in quartiles (Q1-least regular, Q4-most regular) and diabetes (either laboratory-confirmed or self-reported antidiabetic medication use), baseline levels of insulin resistance (HOMA-IR), beta-cell function (HOMA-β), hemoglobin A1c (HbA1c), and their changes over time. Cross-sectionally, lower SRI was associated with higher odds of diabetes (odds ratio [OR]Q1 vs. Q4 = 1.64, 95% CI: 0.98-2.74, ORQ2 vs. Q4 = 1.12, 95% CI: 0.70-1.81, ORQ3 vs. Q4 = 1.00, 95% CI: 0.62-1.62, ptrend = 0.023). The SRI effect was more pronounced in older (aged ≥ 45 years) adults (ORQ1 vs. Q4 = 1.88, 95% CI: 1.14-3.12, pinteraction = 0.060) compared to younger ones. No statistically significant associations were found between SRI and diabetes incidence, as well as baseline HOMA-IR, HOMA-β, and HbA1c values, or their changes over time among adults not taking antidiabetic medication. Our results suggest that sleep regularity represents another sleep dimension relevant for diabetes risk. Further research is needed to elucidate the relative contribution of sleep regularity to metabolic dysregulation and pathophysiology. © Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail [email protected]

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