sleep Tag
13 Oct Insomnia Symptoms May Not Reflect Objective Sleep Measurements
MedicalResearch.com Interview with: Jen-Hao Chen, Ph.D. Assistant Professor, Department of Health Sciences University of Missouri, Columbia, MO 65211 Medical Research: What are the main findings of the study? Dr. Chen: In this study, we mapped four commonly-reported insomnia symptoms (feeling rested when waking up, having trouble falling asleep, waking up during the night, waking up too early and not being able to fall asleep again) to direct assessment of sleep characteristics in the general population of U.S. older adults. While we know older adults frequently complain about their sleep, we know little about how these complain reflect older adults’ actual sleep outcomes. Using innovative actigraphy data of 727 older adults aged 62-91 from the National Social Life, Health and Aging Project, we found that two of these four common report of insomnia symptoms did not match specific objective sleep characteristics as these questions intends to index. The question of feeling rested was not related to any objective sleep characteristic. The question of difficulty falling asleep was not related to the objective measure of time to fall sleep but was related to other objective sleep characteristics. For waking up during the night question, high frequency was associated with more wake time after sleep onset and numbers of wake bout (but was also related to other objective sleep characteristics). For waking up too earlier question, answer of this question was related to earlier wake up time. But again, other objective sleep characteristics also predicted frequency of waking up earlier. In sum, many of the relationships and non-relationships found in this study were unexpected. Findings suggested that these widely used questions did not related to older adults’ sleep outcomes as exactly as the wording suggested. Thus, while older adults’ report of these questions are related to objective sleep characteristics in some ways, insomnia symptoms and objective sleep characteristics did not complete match each other as expected.14 Sep Multiple Sclerosis: Sleep Disorders Both Common and Underdiagnosed
MedicalResearch.com Interview with:
Steven D. Brass, M.D., M.P.H., M.B.A.
PI and Lead Author on the study
Director of Neurology Sleep Clinical Program
Co-Medical Director of Sleep Medicine Laboratory
Associate Clinical Professor in the Department of Neurology
UC Davis Health System 4860 Y Street — Suite 3700
Sacramento, CA 95817
Medical Research: What was the primary finding of your study?
Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome. In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale. There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale and screening positive for Obstructive Sleep Apnea (1.850, with a 95% p-value < 0.001).
12 Sep Does Melatonin Prevent Delirium In Elderly Surgery Patients?
MedicalResearch.com Interview with:
Annemarieke de Jonghe
Academic Medical Center
University of Amsterdam
Departement of Internal Medicine
Section of Geriatric Medicine F4-218
Amsterdam, The Netherlands
Medical Research: What are the main findings of the study?
Dr. de Jonghe: We investigated the preventive properties of melatonin versus placebo in a prospective cohort of elderly hip fracture patients (n=378). We found that 3mg melatonin vs placebo, given for 5 days from the day of admission, did not influence the incidence of delirium. However, in a posthoc analysis we found that more patients in the placebo group more often had a longer lasting delirium.
10 Sep Sleep Patterns Vary By Neighborhood and Socioeconomic Status
MedicalResearch.com Interview with Dr. Shona E. Fang Sc.D. New England Research Institutes, Inc Watertown, Massachusetts Medical Research: What are the main findings of the study? Dr. Fang: Sleep duration varied by neighborhood in Boston, a diverse urban setting. Individual factors, including socioeconomic status, explained some of this variation, while neighborhood socioeconomic status (SES) explained a much larger portion.08 Sep Sleep Difficulties Linked To Shrinking Brain
MedicalResearch.com Interview with:
Dr. Claire Sexton Ph.D.
University of Oxford
Medical Research: What are the main findings of the study?
Dr. Sexton: We found that sleep difficulties (which can include trouble falling asleep, waking up during the night, or waking up too early) were associated with an increased rate of decline in brain volumes over 3-5 years.
04 Sep Poor Sleep Linked To Missed Work Days
MedicalResearch.com Interview with:
Tea Lallukka, PhD
Finnish Institute of Occupational Health &
University of Helsinki, Hjelt Institute, Department of Public Health
University of Helsinki, Finland
Medical Research: What are the main findings of the study?
Dr. Lallukka: Our study used nationally representative survey data linked with
register data on medically certified sickness absence among working
-aged Finnish women and men. We showed consistent associations between
insomnia symptoms, sleep duration, and being tired and sickness
absence. The follow-up lasted around 7 years.
Sickness absence days were derived from comprehensive registers from
the Social Insurance Institution of Finland. The associations were
broadly similar among women and men. Furthermore, they remained even
after considering key correlates of sleep and sickness absence
including socioeconomic position, working conditions, health
behaviors, obesity, and mental and physical health. Health data were
derived from physical examination conducted by field physicians. These
data are more objective, and help provide more robust evidence. We
further covered all key sleep disturbances and sleep duration for more
comprehensive understanding about the contribution of sleep to
sickness absence. Finally, a novel method developed by the authors
(Härkänen & Kaikkonen) allowed us to estimate the difference in
sickness absence days per working year among those reporting and not
reporting different sleep disturbances. Using the difference in days
absent from work, we were further able to estimate the hypothetical
direct costs of sickness absence highlighting notable societal
significance of sleep. Thus, a large part of all costs of sickness
absence are attributable to poor sleep. For example, those sleeping 5
hours or less or 10 hours or more, were absent from work ca 5-9 days
more, as compared to those with optimal sleep length. The optimal
sleep length with the lowest risk of sickness absence was 7 hours 46
minutes for men and 7 hours 38 minutes for women.
31 Jul Adolescent Insomnia Linked to Depression, Anxiety and Chronotype
MedicalResearch.com Interview with: Pasquale K Alvaro School of Psychology University of Adelaide South Australia, Australia Medical Research: What are the main findings of the study? Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP.04 Jul Poor Sleep Plagues Socioeconomically Deprived Neighborhoods
MedicalResearch.com Interview with:
Nathaniel F. Watson, MD, MSc
Professor of Neurology, University of Washington
Co-director, University of Washington Medicine Sleep Center
Director, Harborview Medical Center Sleep Clinic
Seattle, Washington
MedicalResearch: What are the main findings of the study?
Dr. Watson: The Singh Index is a composite measure of socioeconomically deprived neighborhoods. We found that as Singh Index increased, sleep duration reduced. This was true in the total sample of twins, and within twin pairs. The fact that we saw this within twin pairs means the association is present after controlling for genetics and shared environment, which substantially strengthens the association.
03 Jul Poor Sleep Linked To Faster Brain Aging
MedicalResearch.com: Interview with:
Dr. June Chi-Yan Lo
Research Fellow
Cognitive Neuroscience Laboratory
Duke-NUS Graduate Medical School
Singapore
MedicalResearch: What are the main findings of the study?
Dr. Lo: The Duke-NUS study examined the data of 66 older Chinese adults, from the
Singapore-Longitudinal Aging Brain Study. Participants underwent
structural MRI brain scans measuring brain volume and neuropsychological
assessments testing cognitive function every two years. Additionally,
their sleep duration was recorded through a questionnaire. Those who slept
fewer hours showed evidence of faster brain aging and decline in cognitive
performance.
18 Jun Acid Reflux More Frequent During Naps than Nighttime Sleep
MedicalResearch.com Interview with:
Ronnie Fass, M.D., FACG, Professor of Medicine
Case Western Reserve University
Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center
Cleveland, OH
MedicalResearch: What are the main findings of the study?
Dr. Fass: This is the first study to compare the extent of acid reflux between nighttime sleep and daytime naps in patients with Gastroesophageal reflux disease. The results of our study show that naps are associated with significantly greater esophageal acid exposure compared to sleep. Acid reflux events were more frequent and their total duration was longer during naps when compared with acid reflux events during nighttime sleep. Additionally, the fraction of time that the subjects were experiencing acid reflux with pH < 4 was significantly higher during naps than nighttime sleep and subjects experienced more symptoms due to acid reflux during their nap than their sleep.
02 May Adequate Sleep May Help Preserve Memory at Older Ages
MedicalResearch.com Interview with:
Elizabeth Devore, ScD
Associate Epidemiologist
Brigham and Women’s Hospital
Instructor in Medicine, Harvard Medical School
MedicalResearch.com: What are the main findings of the study?
Dr. Devore: In this study, we examined sleep duration and memory performance in a group of ~15,000 women participating in the Nurses’ Health Study. We found that women with sleep durations of 5 or fewer hours/day or 9 or more hours/day, either in midlife or later life, had worse memory at older ages than those sleeping 7 hours/day. In addition, women with sleep durations that changed by two or more hours/day from midlife to later life performed worse on memory tests compared to those whose sleep duration did not change during that time period.The magnitude of these memory differences was approximately equivalent to being 1-2 years older in age.
26 Mar Sleep Loss Associated with Obesity and Diabetes
MedicalResearch.com Interview with: Prof. Dr. Bernd Schultes Endocrinology and Diabetes Internal Medicine eSwiss Medical & Surgical Center Brauerstrasse 97 9016 St. Gallen Schweiz MedicalResearch.com: What are the main findings of the study? Professor Schultes: Sleep loss promotes the development of obesity and diabetes by metabolic and behavioral mechanism. MedicalResearch.com: Were any of the findings unexpected? Professor Schultes:...
20 Feb Good Sleep Habits for Children: Early Consistent Bedtime, No Evening TV
MedicalResearch.com Interview with:
Dr Abi Fisher PhD
Senior Researcher, Cancer Research UK
Health Behaviour Research Centre
University College London
MedicalResearch.com: What are the main findings of the study?
14 Feb Poor Sleep Predicts Pain in Older Adults
MedicalResearch.com Interview:
Dr. John McBeth
Arthritis Research UK Primary Care Centre
Keele University in Staffordshire
MedicalResearch.com: What are the main findings of the study?
Dr. McBeth: In this study, reporting musculoskeletal pain was common with just under half of participants reporting some pain and one quarter reporting widespread pain. Of those who were free of WP at baseline, 19% reported new onset widespread pain at three year follow up.
In addition to osteoarthritis, sleep, cognitive impairment, anxiety and physical health independently predicted the onset of widespread pain and are important treatment targets. In this study non-restorative sleep was the strongest predictor of new onset widespread pain. Sleep is a modifiable target that could improve outcome in this patient group.
12 Feb Optimal Sleep Quality and Morning or Evening Exercise?
MedicalResearch.com Interview with:
Matthew Buman PhD
School of Nutrition and Health Promotion, Arizona State University
Arizona State University, School of Nutrition and Health Promotion
Phoenix, AZ
MedicalResearch.com: What are the main findings of the study?
Dr. Buman: We found that that exercise at night (within 4 hours of bedtime) was not associated with poor sleep compared with individuals that did not exercise before bed. However, we also found that morning exercise appears to be associated with optimal sleep quality.
06 Feb Menopause and Poor Sleep Quality
MedicalResearch.com Interview with: Chih-Jen Chang, MD Department of Family Medicine National Cheng Kung University Hospital, Tainan, Taiwan MedicalResearch.com: What are the main findings of the study? Dr. Chang: Postmenopausal women without vasomotor symptoms (hot flushes and night sweats) have poorer sleep quality than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor sleep quality independently of cardiometabolic factors and lifestyle.05 Jan Sleep Deprivation: Blood Markers of Brain Injury
MedicalResearch.com Interview with:
Jonathan Cedernaes PhD
Department of Neuroscience
Uppsala University Sweden
MedicalResearch.com: What are the main findings of this study?
Dr. Cedernaes: We found that two peripheral blood markers were modestly but significantly increased in healthy young participants after a single night of sleep deprivation, as compared with a normal night of sleep. These two markers, S-100B and NSE, are for example used as markers of acute ischemic injury in the brain, and are also increased following concussions. S-100B is produced mainly by glial cells and also increases after injury to the blood brain barrier. NSE is instead produced by neurons and is regarded as being more specific for neuronal damage, although it can also be produced by peripheral cells.
15 Dec Traumatic Brain Injury: Dietary Therapy
MedicalResearch.com Interview with:
Miranda M. Lim, MD, PhD
Assistant Professor, Sleep Medicine
Division of Pulmonary and Critical Care
Portland VA Medical Center and Oregon Health & Science University
MedicalResearch.com: What are the main findings of the study?
Dr. Lim: People with traumatic brain injury (TBI) often have persistent sleep-wake disturbances including excessive daytime sleepiness and nighttime insomnia, yet the link between a hard blow to the head and drowsiness remains a mystery. We report that a dietary supplement containing branched chain amino acids helps keep mice with TBI awake and alert. The findings suggest that branched chain amino acids, something all humans produce from foods in their normal diets, could potentially alleviate sleep problems associated with TBI. In experiments with brain-injured mice that had trouble staying awake, we found that feeding the animals a dietary supplement enriched with branched chain amino acids improved wakefulness. Treated mice not only stayed continuously awake for longer periods of time, they also showed more orexin neuron activation, neurons known to be involved in maintaining wakefulness. (Previous studies have shown that people with narcolepsy lose significant amounts of orexins.) Branched chain amino acids are the building blocks of neurotransmitters, the chemicals released by neurons in the brain, including glutamate and GABA. We believe that branched chain amino acids act to restore the excitability of orexin neurons after brain injury, which could potentially promote wakefulness. Further studies are needed to pinpoint the exact mechanism of branched chain amino acids effect on sleep pathways in the brain, and to determine any side effects.
06 Dec Obesity: Sleep Quality, Anxiety-Depression, and Quality of Life
MedicalResearch.com Interview with:
Dr G. Neil Thomas,
Regional Director,
NIHR Research Design Service West Midlands
Deputy Director, Master of Public Heath Programme
Reader in Epidemiology
Department of Public Health, Epidemiology and Biostatistics
School of Health and Population Sciences
College of Medical and Dental Sciences The University of Birmingham
Edgbaston, Birmingham, B15 2TT
MedicalResearch.com: What are the main findings of the study?
Dr. Thomas: This population of severely obese individuals (mean BMI 47kg/m2) from a regional specialist weight management service poor sleep quality (Pittsburgh Sleep Quality Index, PSQI) and daytime sleepiness (Epworth Sleepiness Scale) were strongly associated with poorer quality of life (Impact of Quality of Life-Lite (IWQOL-Lite)
06 Dec Sleep disordered breathing as predictor of readmission and mortality
MedicalResearch.com Interview with:
Dr. Takatoshi Kasai, MD, PhD
Department of Cardiology and Cardio-Respiratory Sleep Medicine,
Juntendo University School of Medicine, Tokyo, Japan
MedicalResearch.com: What are the main findings of the study?
Dr. Kasai: Sleep disordered breathing, determined using predischarge nocturnal pulse oximetry, is prevalent and is an independent predictor of the combined end point of readmission and mortality in hospitalized patients with left ventricular systolic dysfunction after acute decompensated heart failure.
19 Nov Less Sleep: More Illness in Adolescents
MedicalResearch.com Interview with:
Dr. Kathryn Orzech PhD
Postdoctoral fellow,Charting the Digital Lifespan
University of Dundee, Scotland, UK
MedicalResesarch.com: What are the main findings of the study?
Dr. Orzech: We found that acute illnesses, such as colds, flu, and gastroenteritis were more common among healthy adolescents with shorter sleep. Specifically, our main analysis found that reported bouts of illness (analyzed on a bouts-of-illness-per-interview basis) declined with longer sleep for both male and female high school students. Longer sleep was also generally protective against school absences that students attributed to illness. There were sex differences, with males reporting fewer illness bouts than females, even with similar sleep durations. This is consistent with another recent study that showed a lower impact of shorter sleep on male adolescents (in that case the outcome was male adiposity), but more research is needed.
We also conducted a secondary analysis to examine total sleep time in matched 6-day windows before illness and before wellness in the same adolescents. Although the number of participants who met our strict criteria for a healthy 6-day window before illness or wellness was only 18 (I was amazed at how difficult it was to find adolescents who reported being completely well for 6 consecutive days), we were able to see a trend in the data toward shorter sleep before illness vs. wellness. Because of the difficulty in comparing sleep before illness vs. wellness, we conducted a qualitative analysis as well, choosing two 17 year old males who were both shorter sleepers, but who reported very different illness profiles - 0 days of illness vs. 35 days of illness across the school term. An in-depth look at notes made by interviewers allowed us to create brief case studies to illustrate that not all shorter sleepers are alike. More irregular sleep timing across weeknights and weekends (much shorter sleep during the week and longer sleep times on the weekend), and a preference for scheduling work and social time later in the evening hours may both contribute to differences in illness outcomes.
18 Nov Sleep Disorders: Accuracy of Portable Sleep Tests
MedicalResearch.com Interview with:
Mohamed El Shayeb MD, MSc
Health Technology and Policy Unit
University of Alberta
3025 Research Transition Facility
Edmonton, Alberta, Canada T6G2V2
MedicalResearch.com: What are the main findings of the study?
Dr. El Shayeb: Our study shows that limited channel level-3 portable devices, used at home, are of good diagnostic value compared to the comprehensive reference-standard level-1 sleep tests conducted in lab in the diagnosis of obstructive sleep apnea (the most common subtype of sleep disordered breathing.)
Were any of the findings unexpected?
None of the findings were unexpected. Level-3 portable devices are commonly used in clinical practice; however, this technology has been widely disseminated, without solid evidence about their diagnostic performance or the subpopulation of sleep disordered breathing patients who are most appropriately diagnosed with them. Our research provides a high level of evidence on the diagnostic performance of these devices, and most importantly, defines the subgroup of patients who are eligible for this test (patients with simple obstructive sleep apnea, and without significant comorbidities.)
16 Nov Sleep Quality and Quantity Affects Cardimetabolic Markers in Children
Posted at 11:36h
in Allergies, Author Interviews, Heart Disease, Metabolic Syndrome, Pediatrics, Sleep Disorders, Surgical Research
MedicalResearch.com Interview with:
Nina Berentzen
Centre for Nutrition, Prevention and Health Services
National Institute for Public Health and the Environment Bilthoven
The Netherlands
MedicalResearch.com: What are the main findings of the study?
Answer: This study in 11-12 year old children shows that self-reported characteristics of sleep quality were not associated with blood pressure and HbA1c; and that in girls, but not in boys, some sleep characteristics were associated with anthropometric outcomes (BMI, waist circumference) and cholesterol levels. More specifically, in girls, longer time in bed was associated with lower BMI and waist circumference; having night-time awakenings with higher total cholesterol, going late to bed while rising early with higher total and HDL cholesterol; and feeling sleepy/tired during daytime with lower HDL cholesterol and with higher total-to-HDL cholesterol ratio. We report new findings for daytime outcomes of sleep quality that were not studied before in relation to cardiometabolic risk; e.g. difficulty with getting up in the morning, feeling rested after waking, and feeling sleepy or tired during the day. Our study therefore offers insight not only in characteristics of sleep at night, but also in consequences of sleep during the day.
05 Nov Good Night’s Sleep Associated with Decreased Calorie Intake in Children
MedicalResearch.com Interview with:
Chantelle Hart, Ph.D.
Associate Professor of Public Health
Center for Obesity Research & Education
Department of Public Health
Philadelphia, PA 19140
MedicalResearch.com: What are the main findings of the study?
Dr. Hart: Following one week of sleeping their typical amount, children 8-11 years old were asked to decrease and increase their time in bed by 1.5 hours/night for one week each in random order. Compared to when children decreased their sleep, when they increased their sleep, they reported consuming 134 kcal/day fewer, had lower fasting levels of leptin, a hunger-regulating hormone that is also highly correlated with the amount of adipose tissue, and weighed approximately 0.5 lbs less. Reported decreases in food intake were most pronounced later in the day.
15 Jul Poor Sleep and Poor Behavior in Children
MedicalResearch.com Interview with: Rebecca J. Scharf MD MPH Developmental and Behavioral Pediatrics Kluge Children's Rehabilitation Center Center for Global Health MedicalResearch.com: What are the main findings of the study? Dr. Scharf: This study examined data from approximately 8,500 children, born in 2001, who were 4 years old at the time of the study. These children...
04 Jul Disruption of Circadian Rhythms and Impaired Intestinal Barrier
MedicalResearch.com Interview with:
Keith Summa MD/PhD Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States of America
Disruption of the Circadian Clock in Mice Increases Intestinal Permeability and Promotes Alcohol-Induced Pathology and Inflammation
MedicalResearch.com: What are the main findings of the study?
Answer: The main findings of the study were that disruption of circadian rhythms, which we achieved using independent genetic and environmental strategies in mice, leads to impaired function of the intestinal epithelial barrier. This loss of epithelial barrier integrity, which has been associated with numerous diseases, results in "gut leakiness," a phenomenon in which endotoxin from gut bacteria can cross the intestinal wall and enter circulation, promoting inflammation. In particular, using in a disease model of gut-derived endotoxemia and inflammation, alcoholic liver disease, we found the circadian disruption interacted with alcohol, leading to increased gut leakiness, inflammation and liver damage.
07 Jun Genetic Sleep Preferences Influence College Major, Career Choice
MedicalResearch.com Interview with: Frederick M. Brown, Ph.D. Associate Professor The Pennsylvania State University Department of Psychology, Cognitive and Wellness Director, Human Performance Rhythms Laboratory MedicalResearch.com: What was the primary finding of your study? Dr. Brown: Time of day of an occupation, as well as a regular versus irregular routine, may influence whether a person wants to go into it or not. Most educational research has focused on academic major selection motivated by job aptitude, personality, and sociocultural factors. Our findings suggest that a person’s genetically determined built-in morning versus evening (M/E) preference for best time of day to work or sleep may influence career choice in two important ways: This M/E preference for work and sleep is related to 1) personality and to 2) the time of day the job is executed. These may interact with how much sleep a person thinks they need. In addition to the personality traits associated with M/E, such as morning people being more introverted and evening people more extroverted, an individual’s choice of major may be influenced by their preference for the typical work hours of a profession, such as a routine 9-to-5 schedule versus irregular evening and weekend work.18 May Sleep Duration as a Predictor of Moderate/High (vs Low) Suicide Risk in Insomnia
Posted at 02:18h
in Author Interviews, Mental Health Research, Sleep Disorders, University of Pennsylvania
MedicalResearch.com eInterview with:
Linden Oliver, MA, Clinical Research Coordinator
University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa
MedicalResearch.com: What are the main findings of the study?
Answer: We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night.
04 Apr Melatonin Secretion and the Incidence of Type 2 Diabetes
Posted at 03:02h
in Author Interviews, Brigham & Women's - Harvard, Diabetes, JAMA, Medical Research Centers, Melatonin, Sleep Disorders
MedicalResearch.com Interview with Dr. Ciaran McMullan MD
from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston Mass
MedicalResearch.com: What are the main findings of the study?
Dr. McMullan: In this observational study performed in non-diabetic women we found that lower nocturnal melatonin secretion predicted future risk of developing type 2 diabetes. When we categorized the individuals by category of nocturnal melatonin secretion we found that those in the lowest category had twice the risk as those in the highest category of nocturnal melatonin secretion. This association remained even after adjusting for other well established risk factors for development of diabetes including body mass index, physical activity, dietary factors, family history of diabetes, smoking and hypertension. This increased risk translates into the lower melatonin secretion group having an additional 5 cases of incident diabetes per 1000 person years than the high melatonin secretion group.