Relationships among sleep timing, sleep duration and glycemic control in Type 2 XXXX in Thailand.

@entity1 @entity6 @entity25 @entity164 @entity413
UNASSIGNED: There is evidence that the sleep and circadian systems play a role in @entity413 metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or evening preference, sleep timing and sleep duration are associated with glycemic control in @entity1 with @entity164 2 @entity6 residing in Thailand. Two hundred and ten @entity164 2 @entity6 @entity1 who were not shift workers completed an interview and questionnaires to collect information on @entity6 history, habitual sleep duration and sleep timing. Chronotype, an individual's tendency for being a "morning" or "evening" @entity1 , was assessed using the Composite Score of Morningness (CSM), which reflects an individual's subjective preference for activities in the morning or evening, as well as mid-sleep time on weekend nights (MSF), which reflects their actual sleep behavior. Most recent hemoglobin A1c (HbA1c) values were retrieved from medical records. Evening preference (as indicated by lower CSM), later bedtime on weekends, and @entity25 correlated with higher HbA1c (r   =   -0.18, p   =   0.01; r   =   0.17, p   =   0.01 and r   =   -0.17, p   =   0.01, respectively), while there was no association between MSF or wake up time and glycemic control. In addition, later bedtime on weekends significantly correlated with @entity25 (r   =   -0.34, p   <   0.001). Hierarchical regression analyses adjusting for age, sex, body mass index, insulin use and @entity6 duration revealed that later bedtime on weekends was significantly associated with poorer glycemic control (B   =   0.018, p   =   0.02), while CSM was not. Mediation analysis revealed that this association was fully mediated by sleep duration. In summary, later bedtime on weekends was associated with @entity25 and poorer glycemic control in @entity1 with @entity164 2 @entity6 . It is likely that @entity1 with later weekend bedtimes curtail their sleep by waking up earlier. Exploring the potential reasons for this phenomenon (e.g. cultural influences, metropolitan lifestyle, environmental factors, family and social obligations) specific to a Thai population may help identify behavioral modifications (i.e. earlier bedtime and/or sleep duration extension) that could possibly lead to improved glycemic control in this population.
