ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1565508
This article is part of the Research TopicPrevention and Treatment Advancements in Diabetic RetinopathyView all 8 articles
Associations of night sleep duration, daytime napping with diabetic retinopathy in patients with type 2 diabetes
Provisionally accepted
- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Aims: The purpose was to evaluate the relationship between night sleep duration, daytime napping and diabetic retinopathy (DR) in type 2 diabetes (T2D) patients and to explore the potential mediating role of metabolic factors. Methods: In this cross-sectional, retrospective study, night sleep and napping were assessed according to the standardized questionnaire. The metabolic factors in the examination were systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI and HbA1c. Multivariate logistic regression, stratified and conjoint analysis were carried out. In addition, causal mediation analysis was performed to explore the mediating role. Results: A total of 2,433 patients [mean (SD) age, 55.82 (11.66) years; 40.07% women] were included in the final analysis. The prevalence of DR was 15.95%. Compared with reference groups, patients with long sleep (OR, 1.31, 95%CI, 1.01-1.70) and long nap (1.09, 1.04-1.23) were both associated with DR, and stratified analysis showed that this association varied among different sex and diabetes duration groups. Conjoint analysis showed that patients with both long sleep and long naps had a significantly increased risk of DR (1.75, 1.13-2.71). Mediation analysis showed that metabolic factors partially mediated this association between night sleep, naps and DR, contributing to 9.8%, 16.3% of the total effects, respectively. Conclusions: Long sleep and long nap was associated with DR and male T2D patients with shorter course (< 5 years) especially need to be vigilant. The effects of night sleep and naps on DR could be superimposed, and metabolic factors partially explain the underlying mechanism.
Keywords: Sleep, napping, type 2 diabetes, Diabetic Retinopathy, Metabolic factors
Received: 23 Jan 2025; Accepted: 04 Jun 2025.
Copyright: © 2025 Xi, Sun, Feng and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanan Cao, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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