Association between habitual sleep duration and SCORE2-Diabetes in individuals with type 2 diabetes

Introduction Individuals with type 2 diabetes (T2DM) often experience insufficient or excessive sleep duration, which may contribute to increased cardiovascular disease (CVD) burden (1). However, evidence on this association remains limited. This study investigated the association between sleep duration and SCORE2-Diabetes (2) among individuals with T2DM. Objective To quantitatively evaluate the relationship between sleep duration and cardiovascular risk, as estimated by SCORE2-Diabetes among individuals aged 40 to 69 years with T2DM and no prior history of CVD. Methods A cross-sectional analysis was conducted using database from the Korea National Health and Nutrition Examination (KNHANES), 2019-2023. After excluding those with a prior history of CVD, we identified individuals aged 40 to 69 years with T2DM who had complete data on self-reported habitual sleep duration and components of SCORE2-Diabetes. Estimates for the moderate-risk region in SCORE2-Diabetes were determined based on the CVD mortality rate in the KNHANES population. We used a general linear model to compare SCORE2-Diabetes scores across habitual sleep duration categories (≤5 h/ day, 6 h/day, 7, h/day, 8 h/day, and ≥9 h/day) in male and female. Tukey’s post-hoc test was applied to compare mean SCORE2-Diabetes values across sleep duration categories, with confidence limits for multiple comparisons. Results Among 1,378 individuals with T2DM, mean age was 59.6 (standard deviation=7.3) years, and 54.3% were male. Least-square means and 95% confidence intervals for SCORE2-diabetes across sleep duration categories (≤5 h/ day, 6 h/day, 7, h/day, 8 h/day, and ≥9 h/day) were 13.9 (12.7-15.1), 13.0 (12.0-14.0), 12.6 (11.7-13.4), 11.7 (10.9-12.5), and 12.8 (11.8-13.8) in male (P-value for trend= 0.04) and 12.0 (10.7-13.4), 12.6 (11.3-13.9), 12.0 (10.8-13.2), 11.0 (9.8-12.2), 9.5 (8.0-10.9) in female (P-value for trend=0.003), respectively. Significant mean differences were observed between ≤5 h/day and 8 h/day in male and 6 h/day and ≥9 h/day in female (Figure). Conclusion Both short and long sleep duration were associated with higher SCORE2-diabetes among individuals with T2DM, suggesting an increased 10-year cardiovascular risk estimation. Further research is warranted to investigate this association addressing several clinically important issues such as sleep quality, severity of T2DM, and risk of specific CVD types associated with sleep duration.