Factors associated with sleep duration in a Chinese middle-aged and elderly diabetic population: a cross-sectional study.

Abstract

Background: The adverse effects of excessively short or long sleep duration on diabetes have been confirmed in previous studies. However, there is a lack of research on the factors associated with sleep duration in diabetic patients, and this study aims to identify the factors associated with sleep duration in diabetes mellitus.

Methods: This study collected data from 2116 middle-aged and elderly individuals with diabetes mellitus who were surveyed by the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Sleep duration was assessed based on patient self-reports, defined as the total amount of sleep patients obtained on average at night over the past month (average nightly sleep duration), it was categorized into short sleep duration (< 6 h), adequate sleep duration (6-9 h) and long sleep duration (> 9 h). Stepwise multivariable multinomial logistic regression was used to explore the associated factors related to short sleep duration (< 6 h) and long sleep duration (> 9 h), using adequate sleep duration as the reference.

Results: The mean self-reported sleep duration in the study sample was (6.34 ± 1.86) hours, with 66.6% reporting adequate sleep duration, 29.6% short sleep duration, and 3.8% long sleep duration. Short sleep duration was positively associated with older age, having low level of education, no health insurance, poor sleep quality, short napping time, and poor self-reported health status. The probability of short sleep duration was lower among good sleep quality (OR = 0.14; 95%CI = 0.11-0.18), good self-reported health status (OR = 0.62; 95%CI = 0.44-0.88). Long sleep duration was positively associated with being male, never smoked, good sleep quality, and traditional Chinese medicine treatment. Long sleep duration was negatively associated with the cognitive function score (OR = 0.94; 95%CI = 0.90-0.99), and having one comorbidity (OR = 0.42; 95%CI = 0.20-0.87).

Conclusion: Sleep duration was influenced by a combination of factors among middle-aged and elderly patients with diabetes in China. The study suggested that we should focus on key populations, such as older adults, individuals without health insurance, those with poor sleep quality, low cognitive function and poor self-reported health status, to promote healthy sleep.