Joint associations of insomnia and sleep duration with prevalent diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

J Diabetes. 2016 May;8(3):387-97. doi: 10.1111/1753-0407.12308. Epub 2015 Jul 21.


Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in U.S. Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse U.S. Hispanic/Latinos.

Methods: Baseline data on sleep quantity and quality were obtained from 15,227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6 h, average >6-9 h, long >9 h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea.

Results: In the weighted population, 14% had diabetes, 28% had insomnia, 9% were short sleepers, and 19% were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95% CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95% CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia.

Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.

Keywords: 2型糖尿病; Hispanic Americans; acculturation; insomnia; sleep; type 2 diabetes mellitus; 失眠症; 文化适应; 睡眠; 西班牙裔美国人.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications
  • Prevalence
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / etiology*
  • United States / epidemiology
  • Young Adult