Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand
© 2015 Taylor & Francis Group, LLC. There is evidence that the sleep and circadian systems play a role in glucose metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or ev...
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th-mahidol.356412018-11-23T16:51:35Z Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand Sirimon Reutrakul Nantaporn Siwasaranond Hataikarn Nimitphong Sunee Saetung Naricha Chirakalwasan Boonsong Ongphiphadhanakul Ammarin Thakkinstian Megan M. Hood Stephanie J. Crowley Faculty of Medicine, Ramathibodi Hospital, Mahidol University Chulalongkorn University King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University Mahidol University Rush University Medical Center Biochemistry, Genetics and Molecular Biology © 2015 Taylor & Francis Group, LLC. There is evidence that the sleep and circadian systems play a role in glucose metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or evening preference, sleep timing and sleep duration are associated with glycemic control in patients with type 2 diabetes residing in Thailand. Two hundred and ten type 2 diabetes patients who were not shift workers completed an interview and questionnaires to collect information on diabetes history, habitual sleep duration and sleep timing. Chronotype, an individuals tendency for being a "morning" or "evening" person, was assessed using the Composite Score of Morningness (CSM), which reflects an individuals subjective preference for activities in the morning or evening, as well as mid-sleep time on weekend nights (MSF), which reflects their actual sleep behavior. Most recent hemoglobin A1c (HbA1c) values were retrieved from medical records. Evening preference (as indicated by lower CSM), later bedtime on weekends, and shorter sleep duration correlated with higher HbA1c (r = -0.18, p = 0.01; r = 0.17, p = 0.01 and r = -0.17, p = 0.01, respectively), while there was no association between MSF or wake up time and glycemic control. In addition, later bedtime on weekends significantly correlated with shorter sleep duration (r = -0.34, p < 0.001). Hierarchical regression analyses adjusting for age, sex, body mass index, insulin use and diabetes duration revealed that later bedtime on weekends was significantly associated with poorer glycemic control (B = 0.018, p = 0.02), while CSM was not. Mediation analysis revealed that this association was fully mediated by sleep duration. In summary, later bedtime on weekends was associated with shorter sleep duration and poorer glycemic control in patients with type 2 diabetes. It is likely that patients with later weekend bedtimes curtail their sleep by waking up earlier. Exploring the potential reasons for this phenomenon (e.g. cultural influences, metropolitan lifestyle, environmental factors, family and social obligations) specific to a Thai population may help identify behavioral modifications (i.e. earlier bedtime and/or sleep duration extension) that could possibly lead to improved glycemic control in this population. 2018-11-23T09:51:35Z 2018-11-23T09:51:35Z 2015-01-01 Article Chronobiology International. Vol.32, No.10 (2015), 1469-1476 10.3109/07420528.2015.1105812 15256073 07420528 2-s2.0-84951567278 https://repository.li.mahidol.ac.th/handle/123456789/35641 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84951567278&origin=inward |
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Biochemistry, Genetics and Molecular Biology Sirimon Reutrakul Nantaporn Siwasaranond Hataikarn Nimitphong Sunee Saetung Naricha Chirakalwasan Boonsong Ongphiphadhanakul Ammarin Thakkinstian Megan M. Hood Stephanie J. Crowley Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
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© 2015 Taylor & Francis Group, LLC. There is evidence that the sleep and circadian systems play a role in glucose metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or evening preference, sleep timing and sleep duration are associated with glycemic control in patients with type 2 diabetes residing in Thailand. Two hundred and ten type 2 diabetes patients who were not shift workers completed an interview and questionnaires to collect information on diabetes history, habitual sleep duration and sleep timing. Chronotype, an individuals tendency for being a "morning" or "evening" person, was assessed using the Composite Score of Morningness (CSM), which reflects an individuals subjective preference for activities in the morning or evening, as well as mid-sleep time on weekend nights (MSF), which reflects their actual sleep behavior. Most recent hemoglobin A1c (HbA1c) values were retrieved from medical records. Evening preference (as indicated by lower CSM), later bedtime on weekends, and shorter sleep duration correlated with higher HbA1c (r = -0.18, p = 0.01; r = 0.17, p = 0.01 and r = -0.17, p = 0.01, respectively), while there was no association between MSF or wake up time and glycemic control. In addition, later bedtime on weekends significantly correlated with shorter sleep duration (r = -0.34, p < 0.001). Hierarchical regression analyses adjusting for age, sex, body mass index, insulin use and diabetes duration revealed that later bedtime on weekends was significantly associated with poorer glycemic control (B = 0.018, p = 0.02), while CSM was not. Mediation analysis revealed that this association was fully mediated by sleep duration. In summary, later bedtime on weekends was associated with shorter sleep duration and poorer glycemic control in patients with type 2 diabetes. It is likely that patients with later weekend bedtimes curtail their sleep by waking up earlier. Exploring the potential reasons for this phenomenon (e.g. cultural influences, metropolitan lifestyle, environmental factors, family and social obligations) specific to a Thai population may help identify behavioral modifications (i.e. earlier bedtime and/or sleep duration extension) that could possibly lead to improved glycemic control in this population. |
author2 |
Faculty of Medicine, Ramathibodi Hospital, Mahidol University |
author_facet |
Faculty of Medicine, Ramathibodi Hospital, Mahidol University Sirimon Reutrakul Nantaporn Siwasaranond Hataikarn Nimitphong Sunee Saetung Naricha Chirakalwasan Boonsong Ongphiphadhanakul Ammarin Thakkinstian Megan M. Hood Stephanie J. Crowley |
format |
Article |
author |
Sirimon Reutrakul Nantaporn Siwasaranond Hataikarn Nimitphong Sunee Saetung Naricha Chirakalwasan Boonsong Ongphiphadhanakul Ammarin Thakkinstian Megan M. Hood Stephanie J. Crowley |
author_sort |
Sirimon Reutrakul |
title |
Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
title_short |
Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
title_full |
Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
title_fullStr |
Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
title_full_unstemmed |
Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand |
title_sort |
relationships among sleep timing, sleep duration and glycemic control in type 2 diabetes in thailand |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/35641 |
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1763492439394353152 |