Cross-sectional and Prospective Associations of Actigraphy-Assessed Sleep Regularity With Metabolic Abnormalities: The Multi-Ethnic Study of Atherosclerosis

Diabetes Care. 2019 Aug;42(8):1422-1429. doi: 10.2337/dc19-0596. Epub 2019 Jun 5.

Abstract

Objective: To cross-sectionally and prospectively investigate the association between irregular sleep patterns, a potential marker for circadian disruption, and metabolic abnormalities.

Research design and methods: In the Multi-Ethnic Study of Atherosclerosis, participants completed 7-day actigraphy at exam 5 (2010-2013) and were prospectively followed throughout exam 6 (2016 to 2017). Sleep regularity was quantified by the 7-day SD of actigraphy-assessed sleep duration and sleep onset timing. Metabolic abnormalities were defined by 1) the National Cholesterol Education Program Adult Treatment Panel III criteria and 2) a data-driven clustering of metabolic factors.

Results: In the exam 5 cross-sectional analysis adjusted for sociodemographic and lifestyle factors (n = 2,003), every 1-h increase in the sleep duration SD was associated with 27% (95% CI 1.10, 1.47) higher odds of metabolic syndrome, and every 1-h increase in the sleep timing SD was associated with 23% (95% CI 1.06, 1.42) higher odds. The associations remained significant with additional adjustment for sleep-related factors including sleep duration. In the prospective analysis (n = 970), the corresponding fully adjusted odds ratio (OR) was 1.27 (95% CI 0.97, 1.65) for sleep duration and 1.36 (1.03, 1.80) for sleep timing. Compared with the cluster of few metabolic changes, every 1-h increase in sleep variability was associated with almost doubled odds for the cluster characterized by incidence of multiple metabolic abnormalities (OR 1.97 [95% CI 1.18, 3.30] for sleep duration and OR 2.10 [95% CI 1.25, 3.53] for sleep timing).

Conclusions: Increased variability in sleep duration and timing was associated with higher prevalence and incidence of metabolic abnormalities even after consideration of sleep duration and other lifestyle factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy*
  • Adult
  • Atherosclerosis / complications
  • Atherosclerosis / ethnology
  • Atherosclerosis / physiopathology*
  • Biomarkers / analysis
  • Cluster Analysis
  • Cross-Sectional Studies
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Male
  • Metabolic Diseases / complications
  • Metabolic Diseases / epidemiology*
  • Metabolic Diseases / ethnology
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Prospective Studies
  • Sleep / physiology*
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / ethnology
  • Sleep Initiation and Maintenance Disorders / etiology
  • Time Factors

Substances

  • Biomarkers