Uncovering Hidden Risk Factors: Sleep-Related Leg Movements and Diabetes

Restless nights can take a toll that goes beyond next-day tiredness. Sleep influences nearly every aspect of our health, and chronic disruptions to sleep patterns have been linked to increased risks for different diseases. To further investigate this connection, a recent study explored the association between sleep-related leg movements and diabetes.

Sleep-related leg movements, or SRLMs, are the twitches, jerks, or other leg movements that can disturb sleep. These can include periodic limb movements of sleep (PLMS), in which the legs repeatedly contract during the night, and restless legs syndrome, in which uncomfortable sensations create an urge to move. Because many people notice these movements themselves or hear about them from a bed partner, SRLMs are typically patient-reported rather than measured in a sleep study.

According to the senior author of the study, Andrey Zinchuk, MD, associate professor of medicine in Yale School of Medicine’s Section of Pulmonary, Critical Care and Sleep Medicine (Yale-PCCSM), SRLMs are fairly common and may be tied to changes in heart rate, blood pressure, and sympathetic nervous system activity.

“Theoretically, these changes could have an impact on chronic conditions linked to sympathetic activation, like hypertension or diabetes,” he explains. Prior work has also shown that PLMS measured in sleep studies can predict the development of diabetes, findings that helped shape the rationale for this study.

"This is the kind of work that can ultimately transform how we approach widespread chronic conditions such as diabetes, hypertension, and heart disease, yielding high-impact change in prevention and management."

-Andrey Zinchuk, MD, MHS

For the study, the researchers analyzed data from more than 9,000 adults in a publicly available health database to determine how frequently sleep-related leg movements were associated with diabetes. They explored whether short sleep duration or inflammation markers in the body might help explain the link.

After adjusting for demographic and clinical factors—such as age, body mass index, sleep apnea, and hypertension—the researchers found that people who reported SRLMs were 72% more likely to have diabetes than those who did not report these movements. Short sleep duration and inflammation explained only a small portion of the relationship.

Zinchuk emphasized that the study is exploratory, a proof of concept that suggests there may be a relationship. “What we need to do next is measure these limb movements and potential mechanisms objectively to see if the link holds,” he says.

Exploratory studies like this are important because they can uncover new disease risk factors, he adds.

According to Zinchuk, this research is a new way of looking at SRLMs, which are typically considered benign. “This is the kind of work that can ultimately transform how we approach widespread chronic conditions such as diabetes, hypertension, and heart disease, yielding high-impact change in prevention and management,” he says.

The study’s first author is Qinglan “Priscilla” Ding, PhD, of Purdue University, who completed her doctorate and post-doctoral training at Yale School of Medicine (YSM) under Zinchuk’s mentorship. Other YSM authors of the study include Brian Koo, MD; Brian Wojeck, MD; and Jason Sico, MD. The study also included collaborators from Indiana University School of Medicine and Capital Medical University in Beijing.

Pulmonary, Critical Care and Sleep Medicine is one of 10 sections in the Yale Department of Internal Medicine. To learn more about Yale-PCCSM, visit PCCSM's website, or follow them on Facebook and X/Twitter.