Trouble falling or staying asleep is linked to 87% greater odds of death from any cause over the next nine years in people with diabetes, a new study finds. A simple question can help clinicians identify patients who may need additional support to lower their risk, investigators say.

The researchers analyzed data from the U.K. Biobank for more than 480,000 participants who were asked the following question: “Do you have trouble falling asleep at night or do you wake up in the middle of the night?” These participants were then followed for a mean period of nine years.

More than one quarter of participants reported that they “usually” experienced sleep disturbances, and almost half experienced these troubles “sometimes.” Mortality risk was highest in those with both diabetes and frequent sleep disturbances, reported corresponding author Kristen L. Knutson, Ph.D., of the Center for Circadian and Sleep Medicine, Northwestern University, Chicago.

Complaints of difficulty falling or staying asleep merit attention by physicians, Knutson and colleagues concluded. “Frequent sleep disturbances may be an important health indicator for clinicians to consider, particularly for diabetes patients,” they stated. “We found that a single question was sufficient to detect mortality risk.”

Diabetes previously has been associated with impaired sleep, obstructive sleep apnea and an increased risk of cardiovascular disease, heart attack and stroke. Other studies have linked type 2 diabetes, worse sleep quality and higher hemoglobin A1c, suggesting poorer glycemic control, the authors stated. This link suggests that impaired glucose control may factor into increased mortality, they said.

Full findings were published in the Journal of Sleep Research.