Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25190
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dc.contributor.authorGreen, Michael Jen_UK
dc.contributor.authorEspie, Colinen_UK
dc.contributor.authorPopham, Franken_UK
dc.contributor.authorRobertson, Tonyen_UK
dc.contributor.authorBenzeval, Michaelaen_UK
dc.date.accessioned2017-04-20T00:04:52Z-
dc.date.available2017-04-20T00:04:52Z-
dc.date.issued2017-03-16en_UK
dc.identifier.other94en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25190-
dc.description.abstractBackground Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence.  Methods A prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. 996 respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA1c ≥ 6.5% or 48 mmol/mol). Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress) as well as for gender and baseline occupational class.  Results Traditional regression yielded an odds ratio (OR) of 1.34 (95% CI: 1.06-1.70) for type 2 diabetes incidence for each additional survey wave in which insomnia was reported. Marginal structural models adjusted for prior covariates (assuming concurrently measured covariates were potential mediators), reduced this OR to 1.20 (95% CI: 0.98-1.46), and when concurrent covariates were also included (viewing them as potential confounders) this dropped further to 1.08 (95% CI: 0.85-1.37).  Conclusions The association between cumulative experience of insomnia and type 2 diabetes incidence appeared confounded. Evidence for a residual causal effect depended on assumptions as to whether concurrently measured covariates were confounders or mediators.en_UK
dc.language.isoenen_UK
dc.publisherBioMed Centralen_UK
dc.relationGreen MJ, Espie C, Popham F, Robertson T & Benzeval M (2017) Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study. BMC Psychiatry, 17, Art. No.: 94. https://doi.org/10.1186/s12888-017-1268-4en_UK
dc.rights© The Author(s). 2017 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectInsomniaen_UK
dc.subjectSleepen_UK
dc.subjectType 2 Diabetesen_UK
dc.subjectLongitudinalen_UK
dc.subjectConfoundingen_UK
dc.subjectCausal Effectsen_UK
dc.subjectMarginal Structural Modelsen_UK
dc.titleInsomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort studyen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/s12888-017-1268-4en_UK
dc.identifier.pmid28302102en_UK
dc.citation.jtitleBMC Psychiatryen_UK
dc.citation.issn1471-244Xen_UK
dc.citation.volume17en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emailtony.robertson@stir.ac.uken_UK
dc.citation.date16/03/2017en_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of Oxforden_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationUniversity of Essexen_UK
dc.identifier.isiWOS:000396764400001en_UK
dc.identifier.scopusid2-s2.0-85015436646en_UK
dc.identifier.wtid533319en_UK
dc.contributor.orcid0000-0002-1962-5874en_UK
dc.date.accepted2017-03-14en_UK
dcterms.dateAccepted2017-03-14en_UK
dc.date.filedepositdate2017-03-21en_UK
dc.subject.tagDiabetesen_UK
dc.subject.tagStatistics and Parameter Estimationen_UK
dc.subject.tagPublic Healthen_UK
dc.subject.tagDiabetes epidemiologyen_UK
dc.subject.tagEpidemiologyen_UK
dc.subject.tagSocial Classen_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorGreen, Michael J|en_UK
local.rioxx.authorEspie, Colin|en_UK
local.rioxx.authorPopham, Frank|en_UK
local.rioxx.authorRobertson, Tony|0000-0002-1962-5874en_UK
local.rioxx.authorBenzeval, Michaela|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2017-03-23en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2017-03-23|en_UK
local.rioxx.filenamegreen_bmcpsyciatry_2017.pdfen_UK
local.rioxx.filecount1en_UK
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