Research shows that going to bed later is more likely to lead to diabetes than getting up early

The importance of sleep to a person is self-evident. People spend about one-third of their lives sleeping. But in this fast-paced era, staying up late and getting up early, either actively or passively, has become the norm. Previous studies have shown that insufficient sleep may lead to serious pathophysiological consequences and even induce death; in addition, insufficient sleep may reduce the function of immune cells in the brain, leading to cognitive decline.

But which one is more harmful to our body, staying up late or getting up early? A prospective cohort study from the United States showed that staying up late was more likely to engage in unhealthy lifestyle behaviors and develop diabetes. The study, titled "Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged US Women," was published in the journal Annals of Internal Medicine.

Source: https://doi.org/10.7326/M23-0728

Sleep type, also known as circadian preference, is a partially genetically determined construct that refers to a person's tendency to sleep earlier or later.

People who prefer to go to bed later at night (such as 3:00 a.m.), wake up later (such as 12:00 noon), or feel energetic later in the day (such as 10:00 p.m.) are considered to have a nocturnal sleep type. An estimated 8% of the population has nocturnal sleep patterns, which are associated with poor metabolic regulation, disrupted glycemic control, metabolic disorders, and higher incidence and prevalence of type 2 diabetes. However, the reasons for the observed association between nighttime sleep patterns and increased diabetes risk are unclear.

Nocturnal sleep patterns may increase diabetes risk through circadian rhythm dysregulation, which occurs when circadian rhythms (including sleep-wake cycles, hormone secretion, thermoregulation, and metabolism) are out of sync with the physical (e.g., light) and social (e.g., work hours) environment. Circadian rhythm imbalance occurs. Circadian rhythm imbalance is particularly common in people with nocturnal sleep patterns and may disrupt circadian rhythms of energy balance and metabolic regulation and promote the onset of diabetes.

It remains unclear to what extent metabolic differences between morning and nighttime sleep chronotypes can be attributed to behavioral differences. Therefore, the purpose of this investigation was to examine the role of modifiable lifestyle factors in the association between sleep chronotype and diabetes risk. Specifically, to examine the association between sleep chronotype and lifestyle factors in middle-aged US women and to assess changes in the relationship between nighttime sleep chronotype and diabetes risk after accounting for modifiable lifestyle behaviors.

The study, called the Nurses' Health Study II (NHSII), is an ongoing prospective cohort study initiated in 1989 of 116,429 women aged 25 to 42 years, primarily registered nurses.

Comprehensive questionnaires on lifestyle and health-related information were mailed to participants at baseline and every two years. The study included 64,590 participants who answered sleep

chronotype questions, lifestyle behavior information, and had no clinical diagnoses of diabetes, cancer, or cardiovascular disease in 2009, leaving 63,676 participants for analysis.

Figure 1: Research flow chart

In addition, the researchers assessed participants' lifestyle behaviors, diet, alcohol consumption, body mass index, physical activity, smoking status, sleep duration, healthy lifestyle scores, incident diabetes and other factors.

The results found that compared to participants with a clear morning sleeper style, people with a clear night sleeper style were more likely to: 1. Work the night shift and have had any job that rotated into the night shift in the past 2 years; 2. Suffer from depression disease. Unhealthy lifestyle behaviors were more common among participants with a clear, consistent nightly sleep pattern.

Figure 2: Baseline characteristics of participants in the Nurses’ Health Study II (2009)

In fully adjusted models, associations between chronotype and individual lifestyle behaviors were observed, with smoking having the strongest association with sleep duration. When the researchers defined nocturnal sleep patterns as non-moderate drinking or binge drinking, a modest positive association between nocturnal sleep patterns and unhealthy drinking was observed.

In a prospective analysis, researchers recorded 1925 cases of diabetes during 469,120 person-years of follow-up and found that people who were night sleepers had the highest risk of developing diabetes compared with people who were early risers.

In summary, compared with middle-aged women with a morning sleep type, middle-aged women with a night sleep type are more likely to have unhealthy lifestyle factors and factors, which may lead to an increased risk of type 2 diabetes. The prospective association between nighttime sleep type and diabetes risk became weaker after adjusting for unhealthy lifestyle (mainly body mass index, physical activity and diet quality).

The association between nocturnal sleep pattern and diabetes risk was attenuated but still positive, taking into account all measured sociodemographic and lifestyle factors, and future studies are needed to evaluate whether lifestyle interventions and personalized shift schedules can Reduce the adverse effects of nighttime sleep patterns on diabetes risk.

It can be seen that the harm of staying up late not only affects our work status during the day, but also easily induces unhealthy lifestyles and causes diabetes. The editor here recommends that everyone develop a healthy living habit of going to bed early and getting up early, and try not to be a night owl as much as possible!

references:

Kianersi S, Liu Y, Guasch-Ferré M, et al. Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged US Women : A Prospective Cohort Study. Ann Intern Med. 2023;176(10):1330-1339. doi :10.7326/M23-0728