The association between sleep duration and incidence of hypertension and diabetes – a Fasa Adults Cohort Study (FACS)

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension and Type 2 Diabetes Mellitus (n=7983). Intervention: Sleep duration (per 1-hour increase per 24-hour day). Primary outcome: Incidence of hypertension (HR 0.90, 95% CI 0.84-0.96, p=0.001).

Q: What does this research mean for the field?

Each one-hour increase in daily sleep duration is associated with a 10% lower risk of incident hypertension over seven years, but sleep duration is not significantly associated with incident diabetes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Maryam Gozin; Hossein Pourmontaseri; Azizallah Dehghan; Zahra Montaseri; Majid Kazemi

doi:10.1186/s12872-026-06759-9

October 22, 2026BMC Cardiovascular DisordersOpen Access

The association between sleep duration and incidence of hypertension and diabetes – a Fasa Adults Cohort Study (FACS)

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Key result

Longer sleep duration is linked to ~10% lower incident hypertension risk per hour increase.

HR 0.90
95% CI 0.84-0.96
P=0.001
n=7,983

Why the study?

Does longer daily sleep duration reduce the incidence of hypertension and type 2 diabetes mellitus in Iranian adults aged 30 to 75 years?

Key Points

To evaluate the relationship between daily sleep duration and the 7-year incidence of hypertension and diabetes in adults from southwestern Iran.
Prospective cohort study analyzing 7935 non-hypertensive subjects and 8735 non-diabetic subjects followed over a 7-year period.
Assessed daily sleep hours at baseline and evaluated disease incidence using multivariable Cox regression models to estimate hazard ratios (HR).
Hypertension developed in 312 participants (3.9%), with each additional hour of sleep significantly reducing hypertension risk in the fully adjusted model (HR: 0.90; 95% CI: 0.84–0.96; p = 0.001).
Diabetes developed in 327 participants (3.7%), but was not significantly associated with sleep duration in the fully adjusted analysis (HR: 1.02; 95% CI: 0.96–1.09; p = 0.500).

Study Design

Type

Cohort (n=7,983)

Multicenter

No

Structured PICO

Does longer daily sleep duration reduce the incidence of hypertension and type 2 diabetes mellitus in Iranian adults aged 30 to 75 years?

P

Population

7,983 non-hypertensive and 8,735 non-diabetic Iranian adults aged 30–75 years (mean age 46.9 years, 50.1% female) followed for 7 years.

E

Exposure

Daily sleep duration (in hours per 24-hour day, including daytime naps), assessed as a continuous variable using the PERSIAN cohort sleep scale.

O

Outcome

Incidence of hypertension (defined as systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg, or use of antihypertensive medications) and incidence of type 2 diabetes mellitus (defined as fasting blood glucose ≥126 mg/dL, HbA1c ≥6.5%, or use of glucose-lowering drugs or insulin) over 7 years (up to 84 months) of follow-up, assessed via annual telephone calls, clinic visits, and medical record review.hard clinical

Main Result

Hazard Ratio: 0.9 (95% CI 0.84–0.96)

p-value: p=0.001

In this large 7-year prospective Iranian adult cohort, longer daily sleep duration was independently associated with a 10% lower risk of developing hypertension per additional hour of sleep, but showed no significant association with incident type 2 diabetes.

Limitations

Sleep duration was evaluated subjectively based on self-reports, which may introduce recall or reporting bias.
Sleep duration included both nighttime sleep and daytime napping without differentiation.
Lack of data on sleep quality, sleep disorders (such as insomnia or sleep apnea), and use of sleep medications.
Work schedules, shift work, and mental health conditions (such as stress and depression) were not assessed, potentially introducing residual confounding.
Relatively narrow range of average sleep duration (mostly 7-8 hours) limited the ability to detect U-shaped associations with diabetes.
Subjective evaluation of sleep duration based on single self-reported 24-hour measures, which may be affected by recall or reporting bias
Sleep duration measurement combined both nighttime sleep and daytime napping
Lack of data on sleep quality, presence of sleep disorders (e.g., insomnia, sleep apnea), work shift, and use of sleep medications
Relatively narrow range of average sleep duration in the population (mostly 7-8 hours), potentially limiting the ability to detect U-shaped associations with diabetes

Implication

Longer sleep may support hypertension prevention targets; leaves open causality and effects on diabetes pending trials.

Abstract

Sleep is one of the most important physiological necessity for human, which is vital for maintaining good health, and insufficient sleep can raise the risk of serious medical conditions. Therefore, this study was aimed to determine the relationship between sleep duration and the incidence of hypertension and diabetes in southwestern Iran. This prospective cohort study, named Fasa Persian Adult Cohort(FACS) comprised of a total of 8735 non-diabetic subjects and 7935 non-hypertensive subjects, was conducted and followed the individuals for 7 years to investigate the incidence of diabetes and hypertension. The daily sleep hours of all participants was determined, and the incidence of diabetes and hypertension were calculated. Cox regression analysis and hazard ratio (HR) estimation were used for further evaluations. After a follow-up of 7 years, 312 (3.9%) and 327 (3.7%) of the participants were diagnosed with hypertension and diabetes, respectively. According to the results of multiple Cox regressions, the lower risk of hypertension was associated with increased sleep hours (HR: 0.90, CI95%:0.84-0.96). However, the risk of diabetes was not significantly associated with sleep duration. Based on the results, short sleep among Iranian adults can be a significant predictor for the occurrence of hypertension, and it can to be designated as a risk factor for hypertension.

Discussion

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Cite This Study

Gozin et al. (2026) conducted a cohort in Hypertension and Type 2 Diabetes Mellitus (n=7,983). Sleep duration (per 1-hour increase per 24-hour day) was evaluated on Incidence of hypertension (HR 0.90, 95% CI 0.84-0.96, p=0.001). Each one-hour increase in daily sleep duration was associated with a 10% lower risk of incident hypertension (HR 0.90, 95% CI 0.84-0.96, p=0.001) over 7 years, but was not associated with diabetes.

synapsesocial.com/papers/6ada63ecf21c0b260092502d https://doi.org/10.1186/s12872-026-06759-9

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The association between sleep duration and incidence of hypertension and diabetes – a Fasa Adults Cohort Study (FACS)

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

The association between sleep duration and incidence of hypertension and diabetes – a Fasa Adults Cohort Study (FACS)

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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