Research led by Westlake Laboratory of Life Sciences and Biomedicine in China has found that inadequate sleep duration and late sleep onset are associated with increased glycemic variability in adults. Continuous glucose monitoring (CGM) data revealed that those with persistent short sleep and late bedtimes experienced greater glycemic variability in blood glucose levels, which may have implications for diabetes prevention and management.

Blood sugar regulation plays a critical role in metabolic health, with fluctuations in glucose levels linked to diabetes complications. Previous research has identified insufficient sleep as a risk factor for impaired glucose metabolism, yet long-term sleep patterns and their effects on glycemic variability remain underexplored. The research team sought to address that knowledge gap by tracking sleep trajectories over multiple years and assessing their impact on blood glucose regulation.

In the study titled "Trajectories of Sleep Duration, Sleep Onset Timing, and Continuous Glucose Monitoring in Adults," published in JAMA Network Open, researchers conducted a prospective cohort study to evaluate the relationship between long-term sleep duration and onset timing with glycemic variability.

The study analysed 1,156 participants, aged 46 to 83, from the Guangzhou Nutrition and Health Study, an ongoing community-based cohort in Guangdong, China. Participants underwent self-reported sleep assessments across multiple visits and wore CGM devices for 14 consecutive days to capture real-time blood glucose fluctuations.

Four distinct sleep duration trajectories emerged: severe inadequate sleep (4.7 to 4.1 hours per night), moderate inadequate sleep (6.0 to 5.5 hours), mild inadequate sleep (7.2 to 6.8 hours), and adequate sleep (8.4 to 8.0 hours)Two sleep onset timing groups were identified: persistent early sleep onset and persistent late sleep onset.

CGM analysis found that individuals in the severe inadequate sleep group had a 2.87% increase in glycemic variability (coefficient of variation, CV) and a 0.06 mmol/L rise in mean daily glucose fluctuations (MODD) compared to those in the adequate sleep group.

Participants in the late sleep onset group had a 1.18% greater glycemic variability and a 0.02 mmol/L increase in MODD. Those experiencing both short sleep and late sleep onset exhibited greater glycemic variability compared to those with either factor alone, indicating a compounded effect on blood sugar regulation.

Long-term inadequate sleep duration and delayed sleep onset correlated with greater blood glucose fluctuations, suggesting that both factors contribute to metabolic dysregulation.

Results suggest that maintaining sufficient sleep duration and earlier sleep onset may be a crucial factor in optimising glycemic control and mitigating diabetes-related risks.

More information: Luqi Shen et al, Trajectories of Sleep Duration, Sleep Onset Timing, and Continuous Glucose Monitoring in Adults, JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2025.0114

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