Chronic sleep disturbances are predictive of incident diabetes in older adults-- variations by gender and race/ethnicity

Abstract

Study Objectives: The current study was conducted to determine whether self-reported chronic sleep disturbances are predictive of incident diabetes in older adults, as well as to determine variations by gender and race/ethnicity. Methods: 7446 participants from the Health and Retirement Study, a nationally-representative longitudinal cohort study of U.S. adults, were followed for eight years, between 20and 2014. Chronic sleep disturbance was defined as self-reported trouble falling asleep or staying asleep “most of the time.” Diabetes was based on self-reported doctor’s diagnosis or a Hemoglobin A1C value >=6.5mg/dl. Hazard ratios were calculated for baseline and on-going sleep disturbances. Results: The average age of participants was 63.5 years. Close to 30% of men and 40% of women reported having a chronic sleep disturbance at baseline. The cumulative incidence of diabetes was 17.7% among men and 15.2% among women. Both men and women who developed diabetes were more likely to report chronic sleep disturbances at baseline than those who did not develop diabetes (men: 32.2% vs. 27.3%; women: 44.2% vs. 36.0%). Women were more likely to develop diabetes within eight years than men after adjustment for demographic covariates (women: HR 1.40 95% CI 1.19-1.63; men HR 1.27 95% CI 0.98-1.66). Black and Hispanic men and women with chronic sleep disturbances had a greater likelihood of developing diabetes within eight years than white men and women. Conclusions: Self-reported chronic sleep disturbance is an independent predictor of incident diabetes in women. The likelihood of developing diabetes among those with chronic sleep disturbances is greater for women than men and greater for blacks and Hispanics than non-black/Hispanic older adults. This finding has both public health and clinical relevance in an aging society.