Too Little or Too Much Sleep Can Worsen Diabetic Patients' Heart Health

Credit: Unsplash / Kinga Howard

Patients with type 2 diabetes who usually sleep under seven hours or over nine hours are at a greater risk of microvascular disease, a recent study found.

Past research has already suggested poor sleep habits such as receiving fewer than six hours or more than 10 hours of sleep, as well as having poor quality of sleep, are linked to a greater diabetes risk. However, not only does sleep duration impact the diabetes risk—it impacts diabetes-related complications in such patients.

Evidence suggests sleep duration variations may influence the risk of developing diabetes-related complications, such as retinopathy and nephropathy. These diseases are major contributors to morbidities associated with type 2 diabetes mellitus.

Investigators from the Steno Diabetes Center Odense at Odense University Hospital in Denmark aimed to explore the relationship between sleep duration and the microvascular disease presence in individuals newly diagnosed with type 2 diabetes mellitus. They conducted an analysis of data from The Specialist Supervised Individualized Multifactorial Treatment of New Clinically Diagnosed Type 2 Diabetes in General Practice, a sub-study from the Danish Centre for Strategic Research in Type Diabetes cohort.

Sleep duration was measured using Axivity AX3 accelerometers, worn for 10 days, and was classified as short (under seven hours), optimal (seven to nine hours), and long (more than nine hours). Microvascular disease was identified by either a urine albumin/creatinine ratio of at least 30 mg/d or the presence of diabetic retinopathy evaluated by either mydriatic retinal imaging or ophthalmoscopy.

Investigators analyzed sleep duration with adjustments for age, sex, body mass index (BMI), systolic blood pressure, smoking habits, HbA1c, duration of diabetes, and antihypertensive treatment.

The study included 396 participants with a mean age of 62 years old. The mean diabetes duration was 3.5 years, and 44% of the study's population were female. Most of the sample was overweight, with a median body mass index of 31 and more than half were on antihypertensive medication. All participants had valid sleep duration measurements, urine albumin/creatinine ratio measurements, and an eye examination.

In total, 12 percen of participants had a short sleep duration, 60 percent had an optimal sleep duration, and 28 percent had a long sleep duration. Additionally, the prevalence of microvascular damage was 38 percent, 18 percent, and 31 pecent in the short, optimal, and long sleep duration groups, respectively.

Investigators saw a short sleep duration had nearly tripled odds of microvascular disease. Likewise, long sleep duration was independently associated with more than doubled odds of microvascular disease.

The team noted age plays a role in the link between short sleep duration and microvascular disease. The likelihood of the association was only 23 percent greater for participants younger than 62 years old, and more than five-fol for people older than 62 years old.

“In recently diagnosed [Type 2 Diabetes Mellitus] patients, both short and long sleep durations are associated with a higher prevalence of microvascular disease compared to optimal sleep duration at night,” investigators concluded. “Age amplifies the association between short sleep duration and microvascular disease, suggesting increased vulnerability among older individuals.

An original version of this article was published on sister site HCPLive.