Joint associations of insomnia and sleep duration with prevalent diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Elizabeth M. Cespedes*, Katherine A. Dudley, Daniela Sotres-Alvarez, Phyllis C. Zee, Martha L. Daviglus, Neomi A. Shah, Gregory A. Talavera, Linda C. Gallo, Josiemer Mattei, Qibin Qi, Alberto R. Ramos, Neil Schneiderman, Rebeca A. Espinoza-Giacinto, Sanjay R. Patel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Background: Inadequate sleep quantity and quality are associated with a higher risk of type 2 diabetes. This relationship is not well-examined in US Hispanics/Latinos, and prior analyses may be confounded by sleep apnea. This cross-sectional study examined joint associations of sleep duration and insomnia with diabetes among diverse US Hispanic/Latinos. Methods: Baseline data on sleep quantity and quality were obtained from 15227 participants (mean age 41; range 18-74 years) from the Hispanic Community Health Study/Study of Latinos. Complex survey multinomial logistic regression was used to examine associations between prevalent diabetes and six phenotypes defined by cross-classifying sleep duration (short ≤6h, average >6-9h, long >9h) and insomnia, adjusting for sex, age, site and Hispanic/Latino background interaction, education, physical activity, diet quality, and sleep apnea. Results: In the weighted population, 14% had diabetes, 28% had insomnia, 9% were short sleepers, and 19% were long sleepers. Compared with those with average sleep and no insomnia, those with short sleep and insomnia were more likely to have diabetes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.02, 2.11). Average sleepers with insomnia (1.28; 95% CI 1.02, 1.61) and long sleepers without insomnia (1.33; 95% CI 1.07, 1.65) also had elevated odds of diabetes. Further adjustment for body mass index attenuated associations, except with long sleep without insomnia. Conclusions: Both decreased quantity and quality of sleep are associated with diabetes in Hispanic/Latinos, with the greatest odds among those with short sleep duration and insomnia. The association is largely explained by obesity.

Original languageEnglish (US)
Pages (from-to)387-397
Number of pages11
JournalJournal of Diabetes
Issue number3
StatePublished - May 1 2016


  • Acculturation
  • Hispanic Americans
  • Insomnia
  • Sleep
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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