Mismatch of Sleep and Work Timing and Risk of Type 2 Diabetes

Jun 26, 2015Diabetes care

Misaligned Sleep and Work Schedules Linked to Higher Risk of Type 2 Diabetes

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Among 64,615 women, early chronotypes had a reduced risk of type 2 diabetes compared to intermediate chronotypes.

Early chronotypes showed an odds ratio of 0.87 for diabetes risk compared to intermediate types after adjustments.
Late chronotypes exhibited no significant difference in diabetes risk, with an odds ratio of 1.04.
Daytime work schedules were associated with a modest diabetes risk reduction (odds ratio 0.81) for early chronotypes.
Early chronotypes working rotating night shifts for less than 10 years had a diabetes risk odds ratio of 0.84.
Shift work exposure for 10 years or more resulted in a nonsignificant increase in diabetes risk for early chronotypes (odds ratio 1.15).
Late chronotypes had a significantly increased diabetes risk (odds ratio 1.51) when working daytime schedules, which was lessened with night shift work.

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OBJECTIVE: To examine whether a mismatch between chronotype (i.e., preferred sleep timing) and work schedule is associated with type 2 diabetes risk.

RESEARCH DESIGN AND METHODS: In the Nurses' Health Study 2, we followed 64,615 women from 2005 to 2011. Newly developed type 2 diabetes was the outcome measure (n = 1,452). A question on diurnal preference ascertained chronotype in 2009; rotating night shift work exposure was assessed regularly since 1989.

RESULTS: Compared with intermediate chronotypes, early chronotypes had a slightly decreased diabetes risk after multivariable adjustment (odds ratio 0.87 [95% CI 0.77-0.98]), whereas no significant association was observed for late chronotypes (1.04 [0.89-1.21]). Among early chronotypes, risk of type 2 diabetes was modestly reduced when working daytime schedules (0.81 [0.63-1.04]) and remained similarly reduced in women working <10 years of rotating night shifts (0.84 [0.72-0.98]). After ≥10 years of shift work exposure, early chronotypes had a nonsignificant elevated diabetes risk (1.15 [0.81-1.63], Ptrend = 0.014). By contrast, among late chronotypes, the significantly increased diabetes risk observed among day workers (1.51 [1.13-2.02]) appeared largely attenuated if their work schedules included night shifts (<10 years: 0.93 [0.76-1.13]; ≥10 years: 0.87 [0.56-1.34]; Ptrend = 0.14). The interaction between chronotype and shift work exposure was significant (Pinteraction = 0.0004). Analyses restricting to incident cases revealed similar patterns.

CONCLUSIONS: In early chronotypes, type 2 diabetes risk increased with increasing duration of shift work exposure, whereas late types had the highest diabetes risk working daytime schedules. These data add to the growing body of evidence that workers could benefit from shift schedules minimizing interference with chronotype-dependent sleep timing.

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Mismatch of Sleep and Work Timing and Risk of Type 2 Diabetes

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