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Daytime napping and risk of type 2 diabetes: a meta-analysis of prospective studies

  • Epidemiology • Original Article
  • Published:
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Abstract

Purpose

Prospective studies reported inconsistent findings on the relationship between daytime napping and risk of type 2 diabetes (T2D). Categorized and dose-response meta-analyses were performed to quantify this relation.

Methods

Potentially eligible studies were identified by searching PubMed and Embase databases. Dose-response effects were assessed by the generalized least squares trend estimation and study-specific summary relative risks (RRs) with 95% confidence intervals (CIs) were computed with a random-effects model.

Results

Seven prospective studies including one US, four European, and two Chinese cohorts involving 249,077 participants and 13,237 cases of T2D were included. The overall analyses showed a 17% increased risk of T2D when comparing habitual nappers with non-nappers (RR = 1.17, 95% CI 1.08–1.27). By region, the summary RR was 1.21 (95% CI 1.17–1.26), 1.15 (95% CI 1.03–1.30) and 1.23 (95% CI 0.87–1.73) for the US, European, and Chinese studies, respectively. Limiting to five studies that excluded subjects with known major chronic disorders yielded a summary RR of 1.16 (95% CI 1.03–1.30). A dose-response analysis suggested an 11% (95% CI 7–16%) increased T2D risk for each increment in daytime napping of 30 min/day and, despite no evidence for nonlinearity (P nonlinearity = 0.65), the increased risk of T2D for short nap (<50 min/day) was dominated by the US study.

Conclusions

This meta-analysis suggests that daytime napping is associated with an increased risk of T2D. Given the limited number of cohorts and inconsistency in terms of methodological and population characteristics across these cohorts, residual confounders and/or reverse causality cannot be fully addressed, and our findings should be interpreted with great caution. Future well-designed prospective studies are still warranted.

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Acknowledgements

G-CC was supported by the 2016 Jiangsu Province Postgraduate Student Training and Innovation Project (KYZZ16_0094) and an award from the China Scholarship Council (CSC No.: 201606920054). L-HC was supported by the Natural Science Foundation of Jiangsu Province (No.: BK20140372). J-YX was supported by the National Natural Science Foundation of China (No.: 81471870). The sponsors had no role in study design, the collection, analysis or interpretation of data, the writing of the report, or the decision to submit the article for publication.

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Author notes

  1. Guo-Chong Chen, Meng-Meng Liu, and Li-Hua Chen contributed equally to this work

Authors and Affiliations

  1. Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren’ai Road, Suzhou, 215123, China

    Guo-Chong Chen, Li-Hua Chen, Khemayanto Hidayat & Li-Qiang Qin

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Guo-Chong Chen

  3. Suzhou Center for Disease Prevention and Control, Suzhou, China

    Meng-Meng Liu

  4. Jiangsu Key Laboratory of Radiation Biology, School of Radiation Medicine and Protection, Soochow University, Suzhou, China

    Jia-Ying Xu

  5. Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China

    Fu-Rong Li

  6. Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou, China

    Li-Qiang Qin

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  1. Guo-Chong Chen
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Corresponding author

Correspondence to Li-Qiang Qin.

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Not applicable for this meta-analysis in which all analyses were based on published literature.

Funding

G-CC was supported by the 2016 Jiangsu Province Postgraduate Student Training and Innovation Project (KYZZ16_0094) and an award from the China Scholarship Council (CSC No.: 201606920054). L-HC was supported by the Natural Science Foundation of Jiangsu Province (No.: BK20140372). J-YX was supported by the National Natural Science Foundation of China (No.: 81471870).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Not applicable for this meta-analysis in which all analyses were based on published literature.

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Chen, GC., Liu, MM., Chen, LH. et al. Daytime napping and risk of type 2 diabetes: a meta-analysis of prospective studies. Sleep Breath 22, 815–824 (2018). https://doi.org/10.1007/s11325-017-1528-z

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  • DOI: https://doi.org/10.1007/s11325-017-1528-z

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