May diabetes patients have trouble sleeping despite not having obesity?

Sleep disturbances, glycaemic control, stress, and coping among diabetic patients: A structural equation modelling approach

BACKGROUND

Sleep disturbances are more prevalent in diabetic patients than in the general population and may consequently be comorbid with hyperglycaemia.

OBJECTIVE

The two study aims were to (1) verify the factors associated with sleep disturbances and glycaemic control and (2) further understand the mediation effects of coping and social support in the relationship among stress, sleep disturbances, and glycaemic control.

METHODS

A cross-sectional study design was used. Data were collected at two metabolic clinics in southern Taiwan. The study recruited 210 patients with type II diabetes mellitus who were aged 20 years or above. Demographic information and data on stress, coping, social support, sleep disturbances, and glycaemic control were collected. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and PSQI scores >5 were considered to indicate sleep disturbances. Structural equation modelling (SEM) approaches were employed to analyse the path association for sleep disturbances in diabetic patients.

RESULTS

The mean age of the 210 participants was 61.43 (standard deviation, SD 11.41) years old, and 71.9 % reported sleep disturbances. The final path model had acceptable model fit indices. Stress perception was divided into stress perceived positively and negatively. Stress perceived positively was associated with coping (β = 0.46, p < .01) and social support (β = 0.31, p < .01), whereas stress perceived negatively was significantly associated with sleep disturbances (β = 0.40, p < .001).

CONCLUSIONS

The study shows that sleep quality is essential to glycaemic control, and stress perceived negatively might play a critical role to sleep quality.

The association between sleep and diabetes outcomes - A systematic review

AIM

This study aimed to systematically review the prevalence of diagnosed sleep disorders in people with diabetes and to determine the association between sleep disorders and blood glucose levels and diabetes outcomes.

METHODS

We conducted a literature search in the following databases: MEDLINE (Pubmed), EMBASE, CINAHL, PsychInfo and Web of Science Citation Index. Meta-analysis (random-effects models) was conducted to estimate the prevalence of sleep disorders in people with diabetes.

RESULTS

Forty-one articles measured the prevalence of sleep disorders in adults with diabetes. The estimated pooled prevalence of sleep disorders in diabetes was estimated to be 52% (95% CI 42-63%). The highest pooled prevalence was observed for unspecified sleep apnea (69%; 95% CI: 59-78%), followed by obstructive sleep apnea (60%; 95% CI 39-80%), and restless leg syndrome (27%; 95% CI 20-34%). Eleven studies examined the association between sleep disorders and diabetes control and complications. The presence of comorbid sleep disorders was associated with increased diabetes outcomes.

CONCLUSIONS

Diagnosed sleep disorders are highly prevalent in people with diabetes. Sleep disorders are associated with diabetes outcomes, though there was considerable heterogeneity across studies.