ArticleBMC public health2025
Promoting healthy sleep patterns for diabetes prevention: joint effects of sleep regularity and sleep duration in a prospective Chinese cohort.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSleep regularity, defined as the consistency of sleep-wake timing across days, is increasingly recognized as an important dimension of sleep health. While inadequate sleep duration is a known risk factor for type 2 diabetes (T2D), the independent contribution of irregular sleep remains poorly understood. Evidence is particularly limited in Asian populations using objective sleep measures.
objectivesTo evaluate the association between accelerometer-derived sleep regularity and incident T2D, and to examine whether meeting recommended sleep duration mitigates the risk associated with irregular sleep patterns.
methodsWe analyzed data from 8,974 insured Chinese adults aged 40-79 years using wearable-linked medical insurance records between August 2020 and June 2023. Raw accelerometry data were collected over 7 consecutive days and processed to compute the Sleep Regularity Index (SRI). Individuals were classified into regular (SRI > 87.3), moderately irregular (71.6-87.3), and irregular (< 71.6) categories. Sleep duration was categorized as adequate or inadequate based on age-specific recommendations. Incident T2D was identified from hospital electronic health records and prescription registries during a median 3.0-year follow-up. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) for T2D across SRI categories and in joint exposure models.
resultsCompared to individuals with irregular sleep, those with moderately irregular (HR 1.22; 95% CI: 1.08-1.39) and regular sleep (HR 1.22; 95% CI: 1.06-1.40) patterns had significantly higher risk of developing T2D. A non-linear association was observed, with the highest risk at mid-range SRI levels. Meeting sleep duration recommendations did not mitigate the elevated risk associated with irregular sleep. Notably, individuals with regular sleep but insufficient duration had a lower, though non-significant, risk of T2D (HR 0.77; 95% CI: 0.56-1.07).
conclusionsIn this database-based Chinese cohort, sleep regularity showed a non-linear association with incident T2D risk, independent of sleep duration. Public health efforts to promote consistent sleep timing may offer additional benefits for diabetes prevention beyond sleep duration alone.
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