Introduction Sleep deprivation produces physiological changes similar to those that occur in the development of diabetes. Sleeping patterns may therefore act as a mediator between socioeconomic status and diabetes.
Methods Data are from the West of Scotland Twenty-07 Study. 953 respondents aged approximately 35 at baseline and followed for 20 years with four repeat interviews had valid data and were free of diabetes at baseline. Diabetes at age 55 was identified by self-report of diabetes, diabetic medication or HbA1c values ≥6.2. Latent class analysis identified four common patterns of sleep over the 20 years: healthy sleep, problems maintaining sleep, developing problems, and chronic sleeping problems. These were used in a path analysis to investigate whether social class differences in diabetes incidence were mediated by sleeping patterns, adjusting for baseline smoking status, BMI and gender.
Results People in a manual social class at baseline were 2.3 times more likely to have diabetes at age 55 compared to those from non-manual classes (95% CIs: 1.32 to 3.99), controlling for baseline characteristics. With further adjustment for long-term sleeping patterns this OR was reduced to 2.03 (95% CI 1.28 to 3.22). Those from a manual social class were more likely to experience chronic sleeping problems than those from non-manual classes (OR: 2.68, 95% CI 1.51 to 4.76) and those with chronic sleeping problems were more likely to develop diabetes than those with healthy sleeping patterns (OR: 4.22, 95% CI 1.99 to 8.96).
Conclusion Findings support partial mediation of socioeconomic differences in diabetes incidence via long-term sleeping problems.
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