Sleep Duration Modifies the Association of Overtime Work With Risk of Developing Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study

Background: Evidence linking working hours and the risk of type 2 diabetes mellitus (T2DM) is limited and inconsistent in Asian populations. No study has addressed the combined association of long working hours and sleep deprivation on T2DM risk. We investigated the association of baseline overtime work with T2DM risk and assessed whether sleep duration modified the effect among Japanese. Methods: Participants were Japanese employees (28,489 men and 4,561 women) aged 30-64 years who reported overtime hours and had no history of diabetes at baseline (mostly in 2008). They were followed up until March 2014. New-onset T2DM was identified using subsequent checkup data, including measurement of fasting/random plasma glucose, glycated hemoglobin, and self-report of medical treatment. Hazard ratios (HRs) of T2DM were estimated using Cox regression analysis. The combined association of sleep duration and working hours was examined in a subgroup of workers (n = 27,590). Results: During a mean follow-up period of 4.5 years, 1,975 adults developed T2DM. Overtime work was not materially associated with T2DM risk. In subgroup analysis, however, long working hours combined with insufficient sleep were associated with a significantly higher risk of T2DM (HR 1.42; 95% CI, 1.11-1.83), whereas long working hours with sufficient sleep were not (HR 0.99; 95% CI, 0.88-1.11) compared with the reference (<45 hours of overtime with sufficient sleep). Conclusions: Sleep duration modified the association of overtime work with the risk of developing T2DM. Further investigations to elucidate the long-term effect of long working hours on glucose metabolism are warranted.