Associations between sleep disturbances and diabetes mellitus among blacks with metabolic syndrome: Results from the Metabolic Syndrome Outcome Study (MetSO)

Abstract

Introduction. The association between sleep disturbances and cardiometabolic diseases has been understudied in blacks with metabolic syndrome.

Methods. This study is a cross-sectional analysis of the Metabolic Syndrome Outcome Study (MetSO) trial. We assessed insomnia symptoms, sleep duration, and risk for sleep apnea. Multivariate logistic regression models evaluated the association between sleep disturbances with diabetes mellitus (DM) and the combined outcomes of DM and hypertension as well as DM and dyslipidemia.

Results. The sample consisted of 1,013 participants, mean age of 62 ± 14 years and 61% female. DM was diagnosed in 60% of the sample. Sleep apnea risk was observed in 48% of the sample, while 10% had insomnia symptoms and 65% reported short sleep duration (< 6 hours). Sleep apnea risk, but not insomnia or sleep duration, was associated with DM (OR 1.66; 95% CI 1.21–2.28), adjusting for age, sex, income, obesity (BMI ≥ 30 kg/m²), tobacco use, alcohol use, hypertension, dyslipidemia, and depression. In fully adjusted models, sleep apnea risk was associated with the combined outcome of DM–hypertension (OR 1.95; 95% CI 1.42–2.69), but not with diabetes–dyslipidemia.

Conclusion. We observed a strong association between sleep apnea risk and diabetes mellitus among blacks with metabolic syndrome.

Key words::

• Black race/ethnicity
• diabetes mellitus
• metabolic syndrome
• sleep apnea

Acknowledgements

We are extremely grateful to the study participants who took the time to participate in this study. Without their participation, this study would not have been possible.

Funding: The authors sincerely acknowledge the financial support received from National Institutes of Health R01MD004113, 1KL2TR000461 (A.R.R.), NCT01946659.

Declaration of interest: This study was not an industry-supported study. No author has a financial relationship with a commercial entity that has interest in the subject of the manuscript. The authors declared no potential conflicts of interest with respect to the financial interest, research, authorship, and/or publication of this article.

The sponsors had no role in the design and conduct of the study: collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication.

Statement of human and animal rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).