Association Of Napping And Night Sleep Duration With Type 2 Diabetes Mellitus

Objectives To explore the relationship between napping and night sleep duration with the risk of type 2 diabetes mellitus(T2DM)prevalence and the dose-response relationship among Henan rural population.Methods A total of 37215 permanent residents of Henan rural area who aged 18-79 years old were included in this research,which was derived from the Henan Rural Cohort study(Chi CTR-OOC-15006699).Information on napping and night sleep duration was assessed using the Pittsburgh Sleep Quality Index(PSQI).Participants were divided into groups according to napping and night sleep duration:(1)napping duration: 0 minutes(reference),1~ minutes,31~ minutes,61~ minutes and ?91 minutes,(2)night sleep duration: <6 hours,6~ hours,7~ hours(reference),8~ hours,9~ hours and ?10 hours.Associations between napping and night sleep duration with T2 DM were evaluated by logistic regression and restricted cubic spline regression.Results 1.The crude and age-standardized prevalence of T2 DM were 9.58% and 5.24% respectively in this population.The average napping and night sleep duration were 57.43 minutes and 7.76 hours,respectively.2.After adjusting the potential confounders,compared with participants who reported no napping,those who had a napping duration of 91 minutes or more were associated with 17%(6%-29%)increases in the risk of T2 DM prevalence.The odds ratio(OR)(95% confidence interval(CI))of T2 DM for every 30 minutes increment was 1.04(1.02-1.06).The relationship between napping duration and T2 DM prevalence risk was statistically significant in those who aged less than 60 years old,overweight,obesity,have low or moderate physical activity and participants who have a history of hypertension as well as female.Multiplicative interaction existed between napping duration and gender(P=0.036).There was a linear dose-response relationship between napping duration and T2DM(P for trend>0.05).3.Compared with participants who slept 7~ hours every night,those who slept ?10 hours had a higher T2 DM prevalence after controlling the confounders.The OR(95% CI)were 1.33(1.13-1.56)and 1.10(1.02-1.19),respectively,for ?10 hours night sleep duration and every standard deviation(1.28 hours)increment based on 7~ hours night sleep duration.As displayed in the subgroup analysis,the relationship between night sleep duration and T2 DM was statistically significant in those who aged 60 years old or more,normal body mass index(BMI),low physical activity,without a history of hypertension as well as female.Multiplicative interaction existed between night sleep duration and age as well as night sleep duration and hypertension(P<0.05).There was a J-shaped relationship between nigh sleep duration and T2 DM prevalence(P for non-linear <0.05).4.Combination of longer night sleep duration(?10 hours)and longer napping duration(?91 minutes)as well as longer night sleep duration(?10 hours)and no napping increased the risk of T2 DM prevalence,when compared with combination of 7~ hours night sleep duration and no napping.The corresponding OR(95% CI)were 1.41(1.05-1.90)and 1.41(1.08-1.84),respectively.There was a positive additive interaction between napping and night sleep duration(RERI,relative excess risk of interaction = 0.023(0.001,0.045)).Conclusions 1.A linear dose-response relationship was observed between napping duration and risk of T2 DM prevalence.2.A J-shaped dose-response relationship was found between night sleep duration and risk of T2 DM prevalence.3.Combined effect of napping and night sleep duration on T2 DM prevalence risk was found.