Poor-quality sleep may be a possible modifiable risk factor in the development of T2DM. We conducted a pilot clinical trial (N=17) to examine the effects of insomnia treatment on insulin resistance in persons with prediabetes. Participants received up to 7 sessions of cognitive behavioral therapy for insomnia (CBT-I), a highly effective, first-line treatment for insomnia. Before and after CBT-I, participants underwent 75-gram oral glucose load test and wore wrist Actiwatches (ActiGraph GT9X Link) to measure sleep indices. Actigraphy data were collected, including wake after sleep onset (WASO; length of periods of wakefulness after sleep onset) and sleep efficiency (SE; ratio of time asleep to time in bed). We calculated the correlation between change in 2-hour post-load glucose and change in WASO and SE in those who completed treatment (at least 6 sessions of CBT-I; N=13). Decreases in WASO and increases in SE after CBT-I (indicating improved sleep) were associated with decreased 2-hour post load glucose levels (see Figure). The estimated Pearson correlations indicated medium-large effect sizes per Cohen’s rule, suggesting a potential reduction in the risk of full T2DM. This small pilot study shows the need for further research on whether treatment of insomnia improves glucose tolerance.


E.S. LeBlanc: None. N. Smith: None. M. Allison: None. G. Clarke: None.


Kaiser Permanente

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