Author ORCID Identifier:
Date of Graduation
7-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Psychology (PhD)
Degree Level
Graduate
Department
Psychological Science
Advisor/Mentor
Veilleux, Jennifer
Committee Member
Makhanova, Anastasia
Second Committee Member
Vargas, Ivan
Third Committee Member
Lin, Yanli
Keywords
continuous glucose monitor; diabetes; glucose; insomnia; multi-level modeling; sleep
Abstract
Insomnia has been associated with impaired glucose metabolism and increased risk for type 2 diabetes (T2D), yet it remains unclear which specific dimensions of sleep disturbance are most strongly linked to glycemic dysfunction. Although both reduced sleep duration and disrupted sleep continuity have been implicated in metabolic dysregulation, prior research has rarely distinguished their relative contributions or examined whether nightly fluctuations in sleep are associated with next-day glucose outcomes. The present study examined whether nightly variations in sleep duration (total sleep time; TST) and sleep continuity disturbance (total wake time; TWT) predicted next-day glucose functioning in adults with insomnia disorder. Participants were 78 adults with chronic insomnia recruited from the greater Northwest Arkansas area. Analyses included 71 participants (Mage = 38.54; SD = 12.07, 41 women, 73.8% White) with sufficient actigraphy and continuous glucose monitoring (CGM) data available for analysis. Participants completed 10 consecutive days of wrist actigraphy, sleep diaries, and CGM assessment. Sleep variables included nightly TST and TWT. Glucose outcomes included next-day fasting glucose, next-day average glucose, and glucose variability (coefficient of variation). Multilevel modeling was used to separate within-person nightly fluctuations from between-person differences in sleep disturbance while accounting for the nested structure of repeated daily observations. Models additionally controlled for perceived stress, biological sex, waist circumference, and night of study. Results indicated that between-person differences in TWT emerged as a consistent predictor of glucose outcomes. Individuals who spent more time awake during the night on average exhibited higher fasting glucose and higher average glucose levels across the monitoring period. Although shorter nightly TST was initially associated with higher next-morning fasting glucose, this effect was attenuated after accounting for TWT. Neither TST nor TWT was significantly associated with glucose variability at either the within-person or between-person level. Overall, findings suggest that stable individual differences in sleep continuity disturbance, rather than nightly fluctuations in sleep duration, may be more strongly associated with glycemic functioning among adults with insomnia. These findings extend prior literature by distinguishing the relative contributions of sleep duration and sleep continuity disturbance to glucose regulation using intensive longitudinal methods. More broadly, results highlight sleep continuity disturbance as a potentially important behavioral target for interventions aimed at improving metabolic health and reducing risk for T2D.
Citation
Walker, J. (2026). Daily Associations Between Sleep and Glucose Outcomes in Adults with Insomnia Disorder. Graduate Theses and Dissertations Retrieved from https://scholarworks.uark.edu/etd/6328
