Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Oct 25, 2025
Open Peer Review Period: Oct 29, 2025 - Dec 24, 2025
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Association between sleep structure and three insulin resistance surrogates in people aged 40-65 years with physical examination in Southwest China: A study based on the assessment of sleep using smart bracelet
ABSTRACT
Background:
There are still insufficient studies exploring its relationship with the Insulin Resistance (IR) surrogates from the perspective of sleep structure.
Objective:
The aim of this study is to apply smart bracelets to monitor the sleep structure parameters of middle-aged and elderly people during natural sleep and investigate their association with the IR surrogates.
Methods:
A total of 723 individuals aged between 40 and 65 participated in the questionnaire surveys, sleep assessments, and regular hospital physical examinations. Sleep assessment involves the respondents wearing a smart bracelet (Honor Band5i) on their non-dominant hand and continuously measuring the sleep of natural people in the real world for three days. Generalised estimating equation regression analysis and robust poisson regression were used to analyse the association between sleep structural parameters and the three IR surrogates, and restricted cubic spline (RCS)regression analysis was used to explore the threshold and dose-response relationship.
Results:
The proportion of REM sleep among the 723 respondents was 17.31% ± 4.76, the proportion of slow-wave sleep was 25.33% (21.83, 28.00), and the proportion of light sleep was 57.67% (53.33,62.00). Multifactorial regression analyses showed that an increase in the duration and proportion of REM sleep was associated with a reduced risk of IR (ORREM%-TyGWHtR =0.993, 95%CI: 0.987-0.999, p=0.029, ORREMmin-TyG =0.997, 95%CI: 0.994-0.999, p=0.038, ORREMmin-METSIR =0.994, 95%CI: 0.990-0.998, p=0.006); No significant associations were found between the length and proportion of slow wave sleep, the length and proportion of light sleep, and the three IR indices (p> 0.05). After the proportion and duration of REM sleep were later dichotomised by the nodes obtained from the RCS analysis, and this association was only observed in the male group in the gender stratification (ORREM%-TyG =0.853, 95%CI: 0.741-0.982, p=0.026, ORREMmin-TyG =0.855,95%CI: 0.742-0.985, p=0.030). Furthermore, even after excluding the REM (%) ≥30% (n=6) or patients with diabetes (n=50), the trend between REM sleep and IR remained consistent.
Conclusions:
This study found that the overall proportion and duration of REM sleep in the middle-aged and elderly population were relatively low. Additionally, the study also discovered that the increase in the proportion of REM sleep is associated with a reduced risk of IR surrogates. This research indicates that monitoring and optimizing the duration and proportion of REM sleep may be a new target for preventing metabolic diseases. Moreover, the widespread use of commercial watches in the home environment will facilitate the assessment of future sleep patterns. This will also provide a basis for people to manage their daily sleep health autonomously.
Citation
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