CClinicalTrials.gg
CompletedNCT03398902Updated Sep 4, 2025Results posted

Personalizing Sleep Interventions to Prevent Type 2 Diabetes in Community Dwelling Adults With Pre-Diabetes

An interventional study of Sleep extension and Habitual sleep in PreDiabetes, sponsored by New York University. Completed at 1 site in United States. Open to participants aged 21 Years to 64 Years. Per ClinicalTrials.gov, last updated 2025-09-04.

Sponsored by New York University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
393
Allocation
Randomized
Ages
21 Years to 64 Years
Sex
All
01

Study summary

This study will use continuous glucose monitoring and actigraphy to examine whether a personalized, daily sleep extension intervention improves glucose regulation for community dwelling, sleep-restricted adults with pre-diabetes. The randomized controlled trial will include 150 adults with pre-diabetes. Sleep extension and habitual sleep groups will complete daily sleep diaries and participate in a weekly 15-minute telephone call or videoconference meeting with a member of the study team (8 sessions total). Data collection will be at 2 time points: pre-randomization and post-intervention (completion of the 8-week intervention). Changes in the percent time glucose is ≥ 140mg/dL at baseline and post-intervention will be established and compared across the sleep extension and habitual sleep arms.

Read the detailed description

Diet and exercise interventions have made great strides in preventing and delaying type 2 diabetes (T2D) onset: benefits that surpass pharmacological interventions in some people. Disappointingly, only half the amount of weight loss and wide ranges in T2D risk reduction have been reported when translating these programs into community settings using less intense, more affordable interventions. Low program participation rates, underscored by reports that only 50% of Americans with prediabetes attempt lifestyle modifications, suggest that approaches focused on calorie restriction and physical activity are only effective for select, highly motivated individuals. Expanding success for heretofore resistant groups and optimizing long term maintenance requires novel approaches beyond diet and exercise. One novel approach is improving sleep.

Associations between sleep duration, sleep patterns, and glucose regulation in healthy adults suggest that interventions targeting these dimensions of sleep will improve glucose regulation. Improved insulin sensitivity has been reported in a small community based daily sleep extension study (N= 16), as well as in a 2-day lab based sleep extension study using a personalized "catch up" sleep intervention in healthy adults (N = 19,). Limited by small sample sizes, controlled lab conditions, and the exclusion of persons at greatest risk for T2D, the role of sleep in mitigating T2D risk remains uncertain. Moreover, sleep extension interventions have applied a generic approach to extending sleep despite variability in individual sleep need. The sleep extension intervention in this study will address how to extend sleep based on individual responses to the intervention.

This study will test the effects of a personalized daily sleep extension intervention versus habitual sleep patterns on the percentage of time glucose is 140 mg/dL in sleep restricted community-dwelling adults at high risk for T2D. Wearable sensor technologies (continuous glucose monitoring and accelerometry) will be used. This study will inform person-specific sleep interventions that improve glycemic responses, thus providing treatment for the pre-diabetic state.

Hypothesis: Personalized daily sleep extension will result in a lower % time glucose is ≥ 140 compared to habitual sleep after 8 weeks of treatment initiation.

02

Conditions studied

  • PreDiabetes

Keywords

  • sleep
  • sleep extension
  • sleep patterns
  • type 2 diabetes
  • glucose regulation
  • behavioral intervention
  • adults
03

Who can participate

Ages eligible
21 Years to 64 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Glycated hemoglobin (Hemoglobin A1C) greater than or equal to 5.7% and less than 6.5%.
  • Restricted sleep defined as less than 6.5 hours average work day sleep (actigraphy confirmed).

Exclusion criteria

Exclusion Criteria:

  • type 2 diabetes (Hemoglobin A1C greater than or equal to 6.5%)
  • pregnancy or lactation (self-report)
  • hemophilia (self-report)
  • moderate/severe or severe depression (PHRQ greater than or equal to 15))
  • alcohol abuse/dependence (Alcohol Use Disorders Identification Test greater than or equal to 10).
  • sleep promoting medications (self-report)
  • hypoglycemic agents (except metformin) (self-report)

    --current chemotherapy treatments (self-report)

  • Shift work during the past 2 months or planned during intervention period (self-report).
  • Trans-meridian travel in the past 4 weeks or planned during intervention period (self-report).
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
393 participants (actual)

Study arms

  • Experimental
    Sleep extension

    Participants in the sleep extension group will keep daily sleep diaries. Sleep diaries will be reviewed with the participant and an instructor trained in Cognitive Behavioral Therapy for Insomnia (CBTI) on a weekly basis. These weekly sessions will take place by telephone or videoconferencing.

    Behavioral: Sleep extension

  • Active comparator
    Habitual sleep

    Participants in the habitual sleep group will be instructed to keep their habitual bedtimes and wake times. Participants will keep daily sleep diaries that will we reviewed by a study team member each week. These weekly sessions will take place by telephone or videoconferencing.

    Other: Habitual sleep

Interventions

  • BehavioralSleep extension

    Based on CBTI principles, the instructor will prescribe bed times and wake times each week to allow for gradual increases in sleep opportunity.

  • OtherHabitual sleep

    The study team member will monitor and encourage participants to keep bedtimes and wake times that matched their baseline bedtimes and wake times.

05

What researchers measure

Primary outcomes

  1. Change in the Percent Time Glucose is ≥ 140 mg/dL From Pre- to Post-intervention

    The primary outcome will be the change in the percent time glucose is ≥ 140mg/dL from pre- to post-intervention estimated from \~7 days of continuous glucose monitoring.

    Time frame: pre-treatment at baseline and post-treatment at ~12 weeks

06

Results

Posted Sep 4, 2025

Participant flow

Participants were recruited from the community by 1) study flyers, 2) past study participants who agreed to be contacted for future research studies, 3) using Epic to identify and contact potential participants, 4) using research registries such as Research Match, and 5) using a peer recruitment strategy.The first participant enrolled in March 2021 and the last participant enrolled in April 2023.

Participant flow — Overall Study
MilestoneControlSleep Intervention
Started9299
Completed4375
Not completed4924

Outcome measures

PrimaryChange in the Percent Time Glucose is ≥ 140 mg/dL From Pre- to Post-intervention

The primary outcome will be the change in the percent time glucose is ≥ 140mg/dL from pre- to post-intervention estimated from \~7 days of continuous glucose monitoring.

Time frame:
pre-treatment at baseline and post-treatment at ~12 weeks
Reported as:
Mean · Percent time glucose >= 140mg/dL
Change in the Percent Time Glucose is ≥ 140 mg/dL From Pre- to Post-intervention
Percent time glucose >= 140mg/dLSleep InterventionControl
Change in the Percent Time Glucose is ≥ 140 mg/dL From Pre- to Post-intervention0.38 ± 4.74-0.49 ± 3.22

Adverse events

Collected over Adverse event data were collected from baseline through the 12 week intervention and the following 2-week post-intervention monitoring period.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Sleep Intervention0/99 (0%)0/99 (0%)13/99 (13.1%)
Control0/92 (0%)0/92 (0%)0/92 (0%)
Most frequent other events
Most frequent other events
EventSleep InterventionControl
compalints of "not feeling well"General disorders7/990/92
complaints of a head coldGeneral disorders6/990/92

Baseline characteristics

Age, Continuous
Age, Continuous(years)Sleep InterventionControlTotal
Mean51.92 ± 9.0352.80 ± 8.46552.35 ± 8.46
Sex: Female, Male
Sex: Female, Male(Participants)Sleep InterventionControlTotal
Female6758125
Male323466
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Sleep InterventionControlTotal
Hispanic or Latino192241
Not Hispanic or Latino7964143
Unknown or Not Reported167
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Sleep InterventionControlTotal
American Indian or Alaska Native000
Asian101222
Native Hawaiian or Other Pacific Islander000
Black or African American442771
White403979
More than one race000
Unknown or Not Reported51419
Percent time Glucose >= 140mg/dL
Percent time Glucose >= 140mg/dL(percentage)Sleep InterventionControlTotal
Mean5.80 ± 8.136.82 ± 8.576.29 ± 8.34
07

Study locations

1 site
  • NYU Langone
    New York, New York 10010, United States
08

References and documents

Publications

  • Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010 Feb;33(2):414-20. doi: 10.2337/dc09-1124. Epub 2009 Nov 12. PubMed 19910503 ↗
  • Holliday EG, Magee CA, Kritharides L, Banks E, Attia J. Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PLoS One. 2013 Nov 25;8(11):e82305. doi: 10.1371/journal.pone.0082305. eCollection 2013. PubMed 24282622 ↗
  • Diabetes Prevention Program Research Group; Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4. Epub 2009 Oct 29. PubMed 19878986 ↗
  • Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512. PubMed 11832527 ↗
  • Perreault L, Temprosa M, Mather KJ, Horton E, Kitabchi A, Larkin M, Montez MG, Thayer D, Orchard TJ, Hamman RF, Goldberg RB; Diabetes Prevention Program Research Group. Regression from prediabetes to normal glucose regulation is associated with reduction in cardiovascular risk: results from the Diabetes Prevention Program outcomes study. Diabetes Care. 2014 Sep;37(9):2622-31. doi: 10.2337/dc14-0656. Epub 2014 Jun 26. PubMed 24969574 ↗
  • Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343-50. doi: 10.1056/NEJM200105033441801. PubMed 11333990 ↗
  • Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu ZX, Lin J, Xiao JZ, Cao HB, Liu PA, Jiang XG, Jiang YY, Wang JP, Zheng H, Zhang H, Bennett PH, Howard BV. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997 Apr;20(4):537-44. doi: 10.2337/diacare.20.4.537. PubMed 9096977 ↗
  • Schellenberg ES, Dryden DM, Vandermeer B, Ha C, Korownyk C. Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med. 2013 Oct 15;159(8):543-51. doi: 10.7326/0003-4819-159-8-201310150-00007. PubMed 24126648 ↗
  • Yoon U, Kwok LL, Magkidis A. Efficacy of lifestyle interventions in reducing diabetes incidence in patients with impaired glucose tolerance: a systematic review of randomized controlled trials. Metabolism. 2013 Feb;62(2):303-14. doi: 10.1016/j.metabol.2012.07.009. Epub 2012 Sep 7. PubMed 22959500 ↗
  • Linmans JJ, Spigt MG, Deneer L, Lucas AE, de Bakker M, Gidding LG, Linssen R, Knottnerus JA. Effect of lifestyle intervention for people with diabetes or prediabetes in real-world primary care: propensity score analysis. BMC Fam Pract. 2011 Sep 13;12:95. doi: 10.1186/1471-2296-12-95. PubMed 21914190 ↗
  • Aziz Z, Absetz P, Oldroyd J, Pronk NP, Oldenburg B. A systematic review of real-world diabetes prevention programs: learnings from the last 15 years. Implement Sci. 2015 Dec 15;10:172. doi: 10.1186/s13012-015-0354-6. PubMed 26670418 ↗
  • Leproult R, Deliens G, Gilson M, Peigneux P. Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction. Sleep. 2015 May 1;38(5):707-15. doi: 10.5665/sleep.4660. PubMed 25348128 ↗
  • Geiss LS, James C, Gregg EW, Albright A, Williamson DF, Cowie CC. Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med. 2010 Apr;38(4):403-9. doi: 10.1016/j.amepre.2009.12.029. PubMed 20307809 ↗
  • Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V; Indian Diabetes Prevention Programme (IDPP). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006 Feb;49(2):289-97. doi: 10.1007/s00125-005-0097-z. Epub 2006 Jan 4. PubMed 16391903 ↗
  • Dunkley AJ, Bodicoat DH, Greaves CJ, Russell C, Yates T, Davies MJ, Khunti K. Diabetes prevention in the real world: effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: a systematic review and meta-analysis. Diabetes Care. 2014 Apr;37(4):922-33. doi: 10.2337/dc13-2195. PubMed 24652723 ↗
  • Cardona-Morrell M, Rychetnik L, Morrell SL, Espinel PT, Bauman A. Reduction of diabetes risk in routine clinical practice: are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis. BMC Public Health. 2010 Oct 29;10:653. doi: 10.1186/1471-2458-10-653. PubMed 21029469 ↗

Study documents

  • Study protocol · Jul 8, 2021
  • Statistical analysis plan · Jul 8, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — The investigators are committed to the principles that NIH has articulated regarding the sharing of study results and resources. The Investigators will make unique research resources readily available for research purposes to individuals within the scientific community after publication. The privacy and rights of participants in the research study will be protected by redacting all identifiers and adopting strategies to minimize the risk of unauthorized disclosure of identifiers in accordance with the data security plan and the participant's Institutional Review Board (IRB)-approved informed consent. The consent language for the R00 study will be worded for possible broad data sharing. Sharing Model Organisms Not Applicable Genome Wide Association Studies Not Applicable

Supporting information: Study protocol, Sap, Icf, Analytic code

09

Registry details

Key details

Study ID
NCT03398902
Lead sponsor
New York University
Collaborators
National Institute of Nursing Research (NINR)
Responsible party
Sponsor
First posted
Jan 16, 2018
Start date
Mar 15, 2021
Primary completion
Sep 18, 2023
Completion
Sep 18, 2023
Results posted
Sep 4, 2025
Last update
Sep 4, 2025

Study contacts

Susan K Malone, PhD
principal investigator · New York University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion