Association of sleep patterns with microvascular complications in individuals with type 2 diabetes: A prospective cohort study.

Background: This study aimed to explore the association between sleep patterns and the risk of microvascular complications in patients with type 2 diabetes.

Methods And Results: Using UK Biobank data, we included the findings for 19,996 patients with type 2 diabetes who were free of diabetic microvascular complications at baseline. The sleep-pattern score was calculated as the sum of the scores for six low-risk sleep-pattern behaviors encompassing sleep duration, chronotype, daytime sleepiness, snoring, insomnia, and daytime napping. Each point increase in sleep-pattern scores is associated with 7%, 15%, and 5% decreased risk of diabetic microvascular complications, nerve, and kidney complications, respectively. Over a median follow-up period of 13.2years, 5635 participants developed diabetic microvascular complications. The hazard ratio (HR; 99% confidence interval [CI]) for diabetic microvascular complications was 1.13 (1.02, 1.25) in participants with >8 hours of sleep vs. those with 7-8 hours of sleep and 1.13 (1.02, 1.24) in participants who usually showed insomnia behaviors vs. those who never or rarely showed insomnia behaviors. The HR (99% CI) for diabetic neuropathy was 1.52 (1.19, 1.85) in participants who usually showed insomnia behaviors vs. those who never or rarely showed insomnia behaviors. The HR (99% CI) for diabetic microvascular complications and diabetic kidney disease was 1.20 (1.06, 1.33) and 1.24 (1.07, 1.42), respectively, in participants who usually showed daytime napping behaviors vs. those who never or rarely showed these behaviors.

Conclusions: Several sleep behaviors were associated with higher risks of diabetic microvascular complications in patients with type 2 diabetes.