#CONDITIONED INSOMNIA DEFINITION FREE#

Psychiatric distress and being overweight/obese may even have reciprocal relationships with sleeping trouble where each aggravates the other.

Indeed, socioeconomic position (SEP), smoking, heavy drinking, physical inactivity, poor diet and psychiatric distress are all associated with increased risk of insomnia symptoms or short sleep duration as well as type 2 diabetes. Whilst observational studies show associations between insomnia symptoms and type 2 diabetes incidence, these may be confounded by other mechanisms. However, treatment of insomnia will only be effective at reducing risk of type 2 diabetes if the relationship between insomnia symptoms and type 2 diabetes is causal. Insomnia can be effectively treated and may be a promising avenue for interventions to reduce type 2 diabetes incidence, as there are plausible biological mechanisms linking sleep loss to the development of type 2 diabetes via increases in insulin resistance and appetite. Insomnia symptoms (defined here as trouble initiating or maintaining sleep) are associated with risk of type 2 diabetes. Evidence for a residual causal effect depended on assumptions as to whether concurrently measured covariates were confounders or mediators. The association between cumulative experience of insomnia and type 2 diabetes incidence appeared confounded. Marginal structural models adjusted for prior covariates (assuming concurrently measured covariates were potential mediators), reduced this OR to 1.20 (95% CI: 0.98-1.46), and when concurrent covariates were also included (viewing them as potential confounders) this dropped further to 1.08 (95% CI: 0.85-1.37). Traditional regression yielded an odds ratio (OR) of 1.34 (95% CI: 1.06-1.70) for type 2 diabetes incidence for each additional survey wave in which insomnia was reported.

Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress) as well as for gender and baseline occupational class. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA 1c ≥ 6.5% or 48 mmol/mol).

#CONDITIONED INSOMNIA DEFINITION FREE#

996 respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. MethodsĪ prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence.

Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations.

Conditioned insomnia definition