Military Sleep Disorders Raise Diabetes Risk

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SEATTLE — Insomnia and other sleep disorders plaguing military servicemembers and veterans could be an independent risk factor for developing diabetes, not just a symptom of depression or post-traumatic stress disorder (PTSD), according to a new study.

The study, led by researchers from the VA Puget Sound Health Care System in Seattle, was published online recently in the journal Diabetes Care.1

Past research has indicated a higher risk of type 2 diabetes associated with sleep characteristics, but study authors pointed out that studies “have not thoroughly assessed the potential confounding effects of mental health conditions associated with alterations in sleep.”

To remedy that, investigators assessed the association between sleep characteristics and self-reported incident diabetes among 47,093 Millennium Cohort Study participants (mean 34.9 years of age; mean BMI 26.0 kg/m2; 25.6% female) who were prospectively followed over a six-year period. The surveys are administered every three years and compile self-reported data on demographics, height, weight, lifestyle, features of military service, sleep, clinician-diagnosed diabetes and mental health conditions assessed by the PRIME-MD Patient Health Questionnaire and the PTSD Checklist-Civilian Version.

During six years of follow-up, 871 incident diabetes cases occurred (annual incidence 3.6/1,000 person-years). In univariate analyses, according to the authors, incident diabetes was significantly more likely among participants with self-reported trouble sleeping, sleep duration of less than six hours and sleep apnea.

Results also indicated that participants reporting incident diabetes were also significantly older, more likely to be of non-white race, having higher body mass index (BMI), less likely to have been deployed and more likely to have reported baseline symptoms of panic, anxiety, post-traumatic stress disorder and depression.

After adjusting for covariates, trouble sleeping (odds ratio 1.21 [95% CI 1.03–1.42]) and sleep apnea (1.78 [1.39–2.28]) were significantly and independently related to incident diabetes, according to the report.

1. Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC, Crum-Cianflone NF; Millennium Cohort Study Team. Sleep characteristics, mental health, and diabetes risk: a prospective study of U.S. military service members in the Millennium Cohort Study. Diabetes Care. 2013 Oct;36(10):3154-61. doi: 10.2337/DC13-0042. Epub 2013 Jul 8. PubMed PMID: 23835691; PubMed Central PMCID: PMC3781550.

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