T Wang1, J Lu1, W Wang1, Y Mu2, J Zhao3, C Liu4, L Chen25, L Shi6, Q Li7, T Yang8, L Yan9, Q Wan10, S Wu11, Y Liu12, G Wang12, Z Luo13, X Tang14, G Chen15, Y Huo16, Z Gao17, Q Su18, Z Ye19, Y Wang20, G Qin21, H Deng22, X Yu23, F Shen24, L Chen25, L Zhao1, M Xu1, J Sun1, Y Bi1, S Lai26, Z T Bloomgarden27, D Li28, G Ning1. 1. State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Chinese People's Liberation Army General Hospital, Beijing, China. 3. Shandong Provincial Hospital affiliated to Shandong University, Jinan, China. 4. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. 5. Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Affiliated Hospital of Guiyang Medical College, Guiyang, China. 7. The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 8. The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. 9. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 10. The Affiliated Hospital of Luzhou Medical College, Luzhou, China. 11. Karamay Municipal People's Hospital, Xinjiang, China. 12. The First Hospital of Jilin University, Changchun, China. 13. The First Affiliated Hospital of Guangxi Medical University, Nanning, China. 14. The First Hospital of Lanzhou University, Lanzhou, China. 15. Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China. 16. Jiangxi People's Hospital, Nanchang, China. 17. Dalian Municipal Central Hospital, Dalian, China. 18. Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 19. Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China. 20. The First Affiliated Hospital of Anhui Medical University, Hefei, China. 21. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 22. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 23. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 24. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 25. Qilu Hospital, University of Shandong School of Medicine, Jinan, China. 26. Johns Hopkins University School of Medicine, Baltimore, MD, USA. 27. Mount Sinai School of Medicine, New York, NY, USA. 28. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
AIMS: Few studies have analysed the effect of sleep duration and snoring on hypertension and glycaemic control in patients with diabetes. This study aims to investigate the relationship of sleep duration and snoring on prevalent hypertension and glycaemic control in people with diabetes. METHODS: In the baseline survey of the REACTION study, 56 032 patients with diabetes were categorized into four groups according to self-reported sleep duration: < 6, 6-7.9, 8-8.9 and ≥ 9 h. Snoring frequency was evaluated as 'usually', 'occasionally' or 'never'. Hypertension was assessed by systolic blood pressure, diastolic blood pressure, self-reported previous diagnosis and antihypertensive medications. 'Good' glycaemic control was defined as HbA1c < 53 mmol/mol (7.0%) and 'poor' glycaemic control as HbA1c ≥ 53 mmol/mol (7.0%). RESULTS: Controlling for potential confounders and intermediates, sleep ≥ 9 h relative to intermediate sleep (6-7.9 h) was significantly associated with prevalent hypertension (OR: 1.25, 95% CI: 1.18-1.32) and poor glycaemic control (OR: 1.11, 95% CI: 1.05-1.18), and a U-shaped association was found between sleep duration and prevalent hypertension (P for quadratic trend = 0.019). Usually snoring was positively associated with prevalent hypertension (OR: 1.30, 95% CI: 1.23-1.37), whereas the association between snoring and poor glycaemic control was only on the borderline of statistical significance. CONCLUSIONS: Compared with a sleep duration of 6-7.9 h, longer sleep duration was associated with a higher prevalence of hypertension and poor glycaemic control in people with diabetes. Moreover, the relationship between sleep duration and prevalent hypertension was U-shaped. These findings may propose important public health implications for diabetes management.
AIMS: Few studies have analysed the effect of sleep duration and snoring on hypertension and glycaemic control in patients with diabetes. This study aims to investigate the relationship of sleep duration and snoring on prevalent hypertension and glycaemic control in people with diabetes. METHODS: In the baseline survey of the REACTION study, 56 032 patients with diabetes were categorized into four groups according to self-reported sleep duration: < 6, 6-7.9, 8-8.9 and ≥ 9 h. Snoring frequency was evaluated as 'usually', 'occasionally' or 'never'. Hypertension was assessed by systolic blood pressure, diastolic blood pressure, self-reported previous diagnosis and antihypertensive medications. 'Good' glycaemic control was defined as HbA1c < 53 mmol/mol (7.0%) and 'poor' glycaemic control as HbA1c ≥ 53 mmol/mol (7.0%). RESULTS: Controlling for potential confounders and intermediates, sleep ≥ 9 h relative to intermediate sleep (6-7.9 h) was significantly associated with prevalent hypertension (OR: 1.25, 95% CI: 1.18-1.32) and poor glycaemic control (OR: 1.11, 95% CI: 1.05-1.18), and a U-shaped association was found between sleep duration and prevalent hypertension (P for quadratic trend = 0.019). Usually snoring was positively associated with prevalent hypertension (OR: 1.30, 95% CI: 1.23-1.37), whereas the association between snoring and poor glycaemic control was only on the borderline of statistical significance. CONCLUSIONS: Compared with a sleep duration of 6-7.9 h, longer sleep duration was associated with a higher prevalence of hypertension and poor glycaemic control in people with diabetes. Moreover, the relationship between sleep duration and prevalent hypertension was U-shaped. These findings may propose important public health implications for diabetes management.
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