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Background <p>Sleep regularity, defined as the consistency of sleep-wake timing across days, is increasingly recognized as an important dimension of sleep health. While inadequate sleep duration is a known risk factor for type 2 diabetes (T2D), the independent contribution of irregular sleep remains poorly understood. Evidence is particularly limited in Asian populations using objective sleep measures.</p> Objectives <p>To evaluate the association between accelerometer-derived sleep regularity and incident T2D, and to examine whether meeting recommended sleep duration mitigates the risk associated with irregular sleep patterns.</p> Methods <p>We analyzed data from 8,974 insured Chinese adults aged 40–79 years using wearable-linked medical insurance records between August 2020 and June 2023. Raw accelerometry data were collected over 7 consecutive days and processed to compute the Sleep Regularity Index (SRI). Individuals were classified into regular (SRI &gt; 87.3), moderately irregular (71.6–87.3), and irregular (&lt; 71.6) categories. Sleep duration was categorized as adequate or inadequate based on age-specific recommendations. Incident T2D was identified from hospital electronic health records and prescription registries during a median 3.0-year follow-up. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) for T2D across SRI categories and in joint exposure models.</p> Results <p>Compared to individuals with irregular sleep, those with moderately irregular (HR 1.22; 95% CI: 1.08–1.39) and regular sleep (HR 1.22; 95% CI: 1.06–1.40) patterns had significantly higher risk of developing T2D. A non-linear association was observed, with the highest risk at mid-range SRI levels. Meeting sleep duration recommendations did not mitigate the elevated risk associated with irregular sleep. Notably, individuals with regular sleep but insufficient duration had a lower, though non-significant, risk of T2D (HR 0.77; 95% CI: 0.56–1.07).</p> Conclusions <p>In this database-based Chinese cohort, sleep regularity showed a non-linear association with incident T2D risk, independent of sleep duration. Public health efforts to promote consistent sleep timing may offer additional benefits for diabetes prevention beyond sleep duration alone.</p>

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Promoting healthy sleep patterns for diabetes prevention: joint effects of sleep regularity and sleep duration in a prospective Chinese cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月14日

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  • Yubin Liu,
  • Wenbo Zhao,
  • Qiaoe Yang,
  • Xiaoyun Wang

摘要

Background

Sleep regularity, defined as the consistency of sleep-wake timing across days, is increasingly recognized as an important dimension of sleep health. While inadequate sleep duration is a known risk factor for type 2 diabetes (T2D), the independent contribution of irregular sleep remains poorly understood. Evidence is particularly limited in Asian populations using objective sleep measures.

Objectives

To evaluate the association between accelerometer-derived sleep regularity and incident T2D, and to examine whether meeting recommended sleep duration mitigates the risk associated with irregular sleep patterns.

Methods

We analyzed data from 8,974 insured Chinese adults aged 40–79 years using wearable-linked medical insurance records between August 2020 and June 2023. Raw accelerometry data were collected over 7 consecutive days and processed to compute the Sleep Regularity Index (SRI). Individuals were classified into regular (SRI > 87.3), moderately irregular (71.6–87.3), and irregular (< 71.6) categories. Sleep duration was categorized as adequate or inadequate based on age-specific recommendations. Incident T2D was identified from hospital electronic health records and prescription registries during a median 3.0-year follow-up. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) for T2D across SRI categories and in joint exposure models.

Results

Compared to individuals with irregular sleep, those with moderately irregular (HR 1.22; 95% CI: 1.08–1.39) and regular sleep (HR 1.22; 95% CI: 1.06–1.40) patterns had significantly higher risk of developing T2D. A non-linear association was observed, with the highest risk at mid-range SRI levels. Meeting sleep duration recommendations did not mitigate the elevated risk associated with irregular sleep. Notably, individuals with regular sleep but insufficient duration had a lower, though non-significant, risk of T2D (HR 0.77; 95% CI: 0.56–1.07).

Conclusions

In this database-based Chinese cohort, sleep regularity showed a non-linear association with incident T2D risk, independent of sleep duration. Public health efforts to promote consistent sleep timing may offer additional benefits for diabetes prevention beyond sleep duration alone.