Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Method
2.1. Study Design and Participants
2.2. Ethical Considerations
2.3. Data Collection
2.4. Measures
2.4.1. Demographic Data and Duration of Diabetes
2.4.2. Sleep Quality
2.4.3. Control of Diabetes
2.4.4. Complications of Diabetes
2.4.5. Lifestyle Behaviors and Sleep Environment
2.4.6. Anxiety and Depression
2.5. Data Analysis
3. Results
3.1. Basic Patient Characteristics
3.2. Status of Diabetes Control, Complications, Nighttime Sleep, and Excessive Daytime Sleepiness
3.3. Factors Related to Nighttime Sleep and Excessive Daytime Sleepiness in Patients with Type 2 Diabetes
4. Discussion
4.1. Contributors to Poor Nighttime Sleep Quality
4.2. Contributors to Excessive Daytime Sleepiness
4.3. Diabetes Control and Complications
4.4. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | M ± SD | Range | n | % |
---|---|---|---|---|
Personal characteristics | ||||
Age | 63.1 ± 10.5 | 33–86 | ||
31–49 | 18 | 10.8 | ||
50–64 | 69 | 41.6 | ||
65–74 | 53 | 31.9 | ||
≥75 | 26 | 15.7 | ||
Sex | ||||
Female | 87 | 52.4 | ||
Male | 79 | 47.6 | ||
Occupation | ||||
No | 61 | 36.8 | ||
Retired | 50 | 30.1 | ||
Yes | 55 | 33.1 | ||
Education | ||||
Illiterate | 18 | 10.8 | ||
Elementary and middle school | 88 | 53.0 | ||
High school and higher | 60 | 36.2 | ||
Marriage | ||||
Married | 122 | 73.5 | ||
Single/widower/widow | 44 | 26.5 | ||
DM duration | 10.1 ± 7.9 | 0.5–51 | ||
0.5–10 years | 104 | 62.7 | ||
11–20 years | 47 | 28.3 | ||
20–30 years | 9 | 5.4 | ||
≥31 years | 6 | 3.6 | ||
BMI | 25.9 ± 3.7 | 17.7–36.2 | ||
<18.5 | 2 | 1.2 | ||
18.5–24 | 55 | 33.3 | ||
24–27 | 48 | 29.1 | ||
27–30 | 35 | 21.2 | ||
≥30 | 25 | 15.2 | ||
Mental status | ||||
Anxiety (≥11) | 11 | 6.6 | ||
Depression (≥11) | 21 | 12.7 | ||
Life style behaviors | ||||
Smoking, current (yes) | 21 | 12.7 | ||
Drinking (sometimes) | 8 | 4.8 | ||
Drinking (often) | 19 | 11.4 | ||
Exercise to sweating (yes) | 86 | 51.8 | ||
Sleep Environment (0 no ~10 extremely) | ||||
Noising (yes, >5) | 18 | 10.8 | ||
Disrupted (yes, >5) | 10 | 6.0 |
Variable | n | % |
---|---|---|
Glycemic control | ||
HbA1C ≤ 7% | 46 | 27.7 |
HbA1C > 7% | 120 | 72.3 |
Blood pressure control | ||
≤130/80 mmHg | 49 | 29.5 |
>130/80 mmHg | 117 | 70.5 |
Lipid control 1 | ||
Normal | 21 | 12.7 |
Abnormal | 145 | 87.3 |
Diabetes control 2 | ||
0 (normal) | 2 | 1.2 |
1 (one abnormal) | 25 | 15.1 |
2 (two abnormal) | 60 | 36.1 |
3 (three abnormal) | 79 | 47.6 |
Complications | ||
Neuropathy 3 | 36 | 21.7 |
Vascular disease 4 | 94 | 56.6 |
Nephropathy 5 | 12 | 7.2 |
Ophthalmological problems 6 | 44 | 26.5 |
No. of complications | ||
0 (normal) | 48 | 28.9 |
1 (one abnormal) | 66 | 39.8 |
2 (two abnormal) | 37 | 22.3 |
3 (three abnormal) | 14 | 8.4 |
4 (four abnormal) | 1 | 0.6 |
Variable | Mean ± SD | Median (IQR) | n | % |
---|---|---|---|---|
Excessive daytime sleepiness | 6.3 ± 4.4 | 5 (3–9) | ||
Normal (ESS 1 < 10) | 126 | 75.9 | ||
Abnormal (ESS ≥ 10) | 40 | 24.1 | ||
Night time sleep quality | 7.0 ± 4.1 | 6 (4–10) | ||
Good (PSQI 2 ≤ 5) | 73 | 44.0 | ||
Poor (PSQI > 5) | 93 | 56.0 | ||
Night time sleep hours | ||||
>7 h | 54 | 32.5 | ||
6–7 h | 60 | 36.2 | ||
5–5.9 h | 36 | 21.7 | ||
<5 h | 16 | 9.6 | ||
Night time sleep latency | ||||
≤15 min | 66 | 39.8 | ||
16–30 min | 51 | 30.7 | ||
31–60 min | 25 | 15.0 | ||
≥60 min | 24 | 14.5 | ||
Sleep efficiency (%) | ||||
≥85 | 99 | 59.6 | ||
75–84 | 33 | 19.9 | ||
65–74 | 16 | 9.6 | ||
<65 | 18 | 10.9 | ||
Sleep disturbances for three or more times a week | ||||
Have to get up to use bathroom | 83 | 50.0 | ||
Cannot get to sleep within 30 min | 51 | 30.7 | ||
Wake up in the middle of night or early morning | 34 | 20.5 | ||
Cough or snore loudly | 30 | 18.1 | ||
Night mare | 22 | 13.3 | ||
Pain | 10 | 6.0 | ||
Feel hot | 3 | 1.8 | ||
Cannot breathe comfortably | 2 | 1.2 | ||
Feel cold | 2 | 1.2 |
PSQ 1 | EDS 2 | |||||
---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | |
Age | 1.020 | 0.990–1.051 | 0.192 | 1.027 | 0.991~1.065 | 0.145 |
Sex 3 | 0.290 | 0.153–0.552 | <0.000 | 0.872 | 0.427–1.781 | 0.707 |
BMI | 1.012 | 0.931–1.100 | 0.782 | 1.048 | 0.952–1.153 | 0.338 |
DM duration (year) | 1.029 | 0.988–1.073 | 0.171 | 1.017 | 0.974–1.062 | 0.435 |
PSQ 1 | - | 4.262 | 1.822–9.971 | 0.001 | ||
Anxiety 4 | 0.938 | 0.275–3.204 | 0.919 | 2.857 | 0.823–9.924 | 0.098 |
Depression 5 | 2.147 | 0.789–5.846 | 0.130 | 1.697 | 0.633–4.553 | 0.294 |
Smoking 6 | 0.845 | 0.338–2.115 | 0.719 | 0.486 | 0.136–1.746 | 0.269 |
Drinking 7 | 1.073 | 0.670–1.719 | 0.769 | 0.621 | 0.315–1.227 | 0.170 |
Exercise to sweating 8 | 0.491 | 0.263–0.916 | 0.025 | 0.909 | 0.446–1.852 | 0.793 |
Noise volume > 5 | 1.265 | 0.465–3.443 | 0.645 | 1.242 | 0.414–3.726 | 0.699 |
Noise disruption > 5 | 3.341 | 0.687–16.241 | 0.135 | 0.776 | 0.158–3.815 | 0.755 |
Glycemic control 9 | 1.098 | 0.555–2.175 | 0.789 | 2.113 | 0.860–5.192 | 0.103 |
Lipid control 10 | 2.302 | 0.899–5.897 | 0.082 | 1.018 | 0.348–2.980 | 0.974 |
BP Control 11 | 0.579 | 0.290–1.155 | 0.121 | 1.138 | 0.516–2.512 | 0.748 |
Diabetes control 12 | 0.999 | 0.669–1.493 | 0.998 | 1.342 | 0.820–2.196 | 0.242 |
Neuropathy 13 | 1.688 | 0.679–4.197 | 0.260 | 1.059 | 0.389–2.881 | 0.911 |
Vascular disease 13 | 1.884 | 1.010–3.515 | 0.047 | 1.200 | 0.582–2.474 | 0.621 |
Nephropathy 13 | 1.624 | 0.469–5.619 | 0.444 | 3.529 | 1.070–11.647 | 0.038 |
Ophthalmological problems 13 | 3.100 | 1.437–6.690 | 0.004 | 1.259 | 0.573–2.764 | 0.566 |
Complications 14 | 1.740 | 1.217–2.488 | 0.002 | 1.165 | 0.803–1.690 | 0.422 |
OR 1 | 95% CI | p | ||
---|---|---|---|---|
Poor night time sleep quality 2 | ||||
Age | 0.99 | 0.956 | 1.025 | 0.589 |
Sex | 0.29 | 0.147 | 0.584 | 0.000 |
Exercise to sweating | 0.48 | 0.244 | 0.941 | 0.033 |
Ophthalmological problems | 3.17 | 1.316 | 7.633 | 0.010 |
Vascular disease | 1.35 | 0.681 | 2.681 | 0.389 |
Nagelkerke R2 = 0.213 | ||||
Excessive daytime sleepiness 3 | ||||
Age | 1.03 | 0.992 | 1.071 | 0.127 |
Sex | 1.27 | 0.559 | 2.859 | 0.573 |
Sleep quality | 4.35 | 1.765 | 10.732 | 0.001 |
Nephropathy | 3.78 | 1.031 | 13.848 | 0.045 |
Nagelkerke R2 = 0.164 |
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Kuo, C.-P.; Lu, S.-H.; Huang, C.-N.; Liao, W.-C.; Lee, M.-C. Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 3025. https://doi.org/10.3390/ijerph18063025
Kuo C-P, Lu S-H, Huang C-N, Liao W-C, Lee M-C. Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(6):3025. https://doi.org/10.3390/ijerph18063025
Chicago/Turabian StyleKuo, Ching-Pyng, Shu-Hua Lu, Chien-Ning Huang, Wen-Chun Liao, and Meng-Chih Lee. 2021. "Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 18, no. 6: 3025. https://doi.org/10.3390/ijerph18063025