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The joint secular trends of sleep quality and diabetes among the US adults, 2005-2018.

CONTEXT
The sleep quality has been related to the risk of diabetes; however, little is known about the prevalence of diabetes in the U.S according to the levels of sleep quality.


OBJECTIVE
To examine the joint secular trends of the overall sleep quality and diabetes among US adults from 2005-2006 to 2017-2018.


DESIGN
Seven cycles of cross-sectional National Health and Nutrition Examination Survey (NHANES) data between 2005-2006 to 2017-2018.


SETTING
Nationally representative population-based data.


PARTICIPANTS
Nonpregnant adults aged 20 years or older were eligible for the study.


EXPOSURES
Survey cycle.


MAIN OUTCOME
A healthy sleep score was calculated to represent an overall sleep quality. The estimated prevalence of diabetes and mean levels of fasting plasma glucose (FPG), glycated hemoglobin, and insulin resistance.


RESULTS
Both the estimated age-standardized prevalence of diabetes and changing trend in prevalence of diabetes varied by the overall sleep quality groups. The highest prevalence of diabetes was consistently observed in the low sleep quality group in each cycle, in which a significantly increasing trend was also noted across cycles (P-trend=0.004). In contrast, the lowest prevalence of diabetes was consistently observed in the high sleep quality group in each cycle, in which no increasing trend over time was observed (P-trend=0.346).


CONCLUSIONS
The overall sleep quality decreased significantly between 2005-2006 and 2017-2018 among US adults. The estimated prevalence of diabetes and related measures only increased in participants with low or medium overall sleep quality but remained stable in participants with high sleep quality.