Investigating the non-linear association between sleep duration and type 2 diabetes: conventional and Mendelian randomization analyses from the UK Biobank

J Diabetes Investig. 2025 Jun;16(6):1126-1137. doi: 10.1111/jdi.70039. Epub 2025 Apr 3.

Abstract

Aims/introduction: Previous observational studies have suggested an increased risk of type 2 diabetes associated with both short and long sleep duration. However, there remains uncertainty, particularly regarding the adverse effects of long sleep duration. We investigated the association between self-reported questionnaire-based and objectively measured accelerometer-derived sleep duration and the risk of type 2 diabetes using data from the UK Biobank.

Materials and methods: First, we performed conventional Cox regression analysis with restricted cubic splines to illustrate the potentially non-linear association between sleep duration and the risk of type 2 diabetes. Second, we performed non-linear Mendelian randomization (MR) analysis using the doubly-ranked method with 85 and 20 genetic variants associated with questionnaire-based and accelerometer-based sleep duration, respectively. Third, we performed two-sample MR analysis.

Results: The results of conventional analysis of accelerometer-derived sleep duration did not suggest a strong association between longer sleep duration and type 2 diabetes risk (hazard ratio [HR] of ≥10 h compared with 7-8 h, 1.08; 95% confidence interval [CI], 0.92-1.27). The results of non-linear MR showed no strong evidence for an increased risk of type 2 diabetes associated with questionnaire-based longer sleep duration (HR of 9 h compared with 7 h, 0.77; 95% CI, 0.52-1.15). This finding was consistent with non-linear MR of accelerometer-derived sleep duration (HR of 9 h compared with 7 h, 0.78; 95% CI, 0.29-2.06).

Conclusions: Our findings suggest that longer sleep duration does not play a major role in the development of type 2 diabetes.

Keywords: Diabetes mellitus, type 2; Mendelian randomization; Sleep duration.

MeSH terms

  • Accelerometry
  • Aged
  • Biological Specimen Banks
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mendelian Randomization Analysis*
  • Middle Aged
  • Prognosis
  • Risk Factors
  • Sleep Duration
  • Sleep* / physiology
  • Surveys and Questionnaires
  • Time Factors
  • UK Biobank
  • United Kingdom / epidemiology