Research Article The Association of Sleep Disorder, Obesity Status, and Diabetes Mellitus among US Adults—The NHANES 2009-2010 Survey Results

permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. To examine the association between sleep disorders, obesity status, and the risk of diabetes in adults, a total of 3668 individuals aged 40+ years from theNHANES 2009-2010 withoutmissing information on sleep-related questions, measurements related to diabetes, and BMI were included in this analysis. Subjects were categorized into three sleep groups based on two sleep questions: (a) no sleep problems; (b) sleep disturbance; and (c) sleep disorder. Diabetes was defined as having one of a diagnosis from a physician; an overnight fasting glucose> 125 mg/dL; Glycohemoglobin> 6.4%; or an oral glucose tolerance test> 199mg/dL. Overall, 19 % of subjects were diabetics, 37 % were obese, and 32 % had either sleep disturbance or sleep disorder. Using multiple logistic regression models adjusting for covariates without including BMI, the odds ratios (OR, (95 % CI)) of diabetes were 1.40 (1.06, 1.84) and 2.04 (1.40, 2.95) for those with sleep disturbance and with sleep disorder, respectively. When further adjusting for BMI, the ORs were similar for those with sleep disturbance 1.36 (1.06, 1.73) but greatly attenuated for those with sleep disorders (1.38 [0.95, 2.00]). In conclusion, the impact of sleep disorders on diabetes may be explained through the individuals ’ obesity status. 1