New Study: More REM Sleep Lowers Risk of 83 Diseases, Including Diabetes

A large-scale study published in PLOS Medicine reveals that a greater proportion of rapid eye movement (REM) sleep is associated with a lower risk of 83 health conditions, including diabetes. The findings emerged after researchers analyzed real-world data from nearly 100,000 UK Biobank participants, making it one of the largest analyses of sleep stages ever conducted.

Unlike previous research that relied on participants' reports of sleep duration, this study used an accelerometer worn on the wrist for a week. The device objectively recorded sleep duration, stages, and regularity. Over an average of 8.9 years of monitoring, researchers recorded the onset of disease or death in 95,559 adults with an average age of 56.2 years.

As a result, those who spent more time in the REM phase—the sleep stage often associated with dreaming—had a lower risk of more than 80 diseases. Meanwhile, deep sleep was correlated with a reduced risk of only seven conditions. Conversely, excessive light sleep actually increased the risk of major depressive disorder, although it reduced the risk of heart failure and cellulitis.

Researchers also highlighted the possibility of reverse causality. Depression, for example, can cause sleep disturbances, not the other way around. The findings underscore that the relationship between sleep and disease is not always unidirectional. Sleep regularity also plays a role: irregular sleep patterns were associated with an increased risk of several disorders, including hypertension and mood disorders.

"Waking up at the same time every day helps the brain regulate when you are awake and when your body needs sleep," said Scott Nass, a board-certified family physician at SwiftCareMD, who was not involved in the study.

Nass added that this routine should also be maintained on weekends. According to him, extra sleep after a difficult night actually shifts sleep patterns and makes it harder for the brain the following night. He also recommended morning sunlight exposure to strengthen circadian rhythm.

Meanwhile, Chelsie Rohrscheib, PhD, a sleep expert and neuroscientist at Wesper, emphasized the importance of a dark, quiet, and cool room (18–21 degrees Celsius). "Core body temperature needs to drop to initiate and maintain sleep," she explained. She recommended a 30–60 minute pre-sleep routine with relaxing activities such as light reading, meditation, or deep breathing, and avoiding phone screens.

Rohrscheib also recommended exercise that raises heart rate for at least 30 minutes a day to burn excess cortisol, a hormone that can disrupt sleep quality.

Indonesian Context

For Indonesians, these findings are relevant given the rising prevalence of diabetes. Data from the International Diabetes Federation (IDF) show that around 19.5 million Indonesian adults were living with diabetes in 2021, and that number is projected to surge. Sleep disorders, including sleep apnea and short sleep duration, often go undiagnosed. Shift work, device use before bed, and urban noise are risk factors that are rarely discussed in public health campaigns.

The study also highlights the importance of education about sleep stages, not just duration. So far, health campaigns in Indonesia have focused more on "8 hours of sleep" without detailing quality. Yet an adequate proportion of REM sleep can be a marker of metabolic and neurological health. With a high burden of non-communicable diseases, sleep interventions could be a cost-effective prevention strategy.

Going forward, the question is: is Indonesia's health system ready to include sleep quality assessment as part of routine screening? Or will we continue to ignore the one-third of life that determines two-thirds of our health?