{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:52:39Z","timestamp":1790866359298,"version":"4.1.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Understanding the interplay between trajectories of sleep duration, sleep onset timing, and glycemic dynamics is crucial for improving preventive strategies against diabetes and related metabolic diseases.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the associations of sleep duration and onset timing trajectories with continuous glucose monitoring (CGM)\u2013derived glycemic metrics in adults.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study analyzed data collected from January 2014 to December 2023 in the Guangzhou Nutrition and Health Study, a prospective cohort in Guangdong province, China, among participants aged 46 to 83. Participants who had repeated sleep assessments at several study visits and were equipped with CGM devices at the last visit were included. Data analyses were conducted between January and June 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n The trajectories of sleep duration and onset timing were constructed using self-report sleep duration and sleep onset timing, recorded at multiple study visit points.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Measurements of glycemic variability and glycemic control were collected using a masked CGM device worn by patients for 14 consecutive days. Huber robust regression models were used to assess the associations between sleep trajectories and CGM-derived metrics.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In this study of 1156 participants (mean [SD] age, 63.0 [5.1] years, 816 [70.6%] women), we identified 4 distinct sleep duration trajectory groups: severe inadequate, moderate inadequate, mild inadequate, and adequate. Severe sleep inadequacy was associated with an increment of glycemic variability indicators: 2.87% (95% CI, 1.23%-4.50%) for coefficient of variation and 0.06 (95% CI, 0.02-0.09) mmol\/L for mean of daily differences. We found 2 trajectories of sleep onset timing: persistent early and persistent late groups. Late sleep onset was associated with larger coefficient of variation (\u03b2\u2009=\u20091.18%; 95% CI, 0.36%-2.01%) and mean of daily differences (\u03b2\u2009=\u20090.02 mmol\/L; 95% CI, 0.01-0.04 mmol\/L). Inappropriate sleep duration and timing trajectories in combination were associated with greater glycemic variability.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of middle-aged and older participants, persistent inadequate sleep duration and late sleep onset, whether alone or in combination, were associated with greater glycemic variability. These findings emphasize the importance of considering both sleep duration and timing for optimizing glycemic control in the general population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.0114","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T11:00:53Z","timestamp":1741172453000},"page":"e250114","source":"Crossref","is-referenced-by-count":21,"title":["Trajectories of Sleep Duration, Sleep Onset Timing, and Continuous Glucose Monitoring in Adults"],"prefix":"10.1001","volume":"8","author":[{"given":"Luqi","family":"Shen","sequence":"first","affiliation":[{"name":"Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bang-yan","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanglong","family":"Gou","sequence":"additional","affiliation":[{"name":"Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China"},{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxiu","family":"Liang","sequence":"additional","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haili","family":"Zhong","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congmei","family":"Xiao","sequence":"additional","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"},{"name":"Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiqi","family":"Shi","sequence":"additional","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelei","family":"Miao","sequence":"additional","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanqing","family":"Fu","sequence":"additional","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Sheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China"},{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou, China"},{"name":"Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China"},{"name":"Research Center for Industries of the Future, School of Life Sciences, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"zoi250011r1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1146\/annurev-psych-010213-115205","article-title":"Why sleep is important for health: a psychoneuroimmunology perspective.","volume":"66","author":"Irwin","year":"2015","journal-title":"Annu Rev Psychol"},{"key":"zoi250011r2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s13098-015-0018-3","article-title":"The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms.","volume":"7","author":"Brian\u00e7on-Marjollet","year":"2015","journal-title":"Diabetol Metab 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