Effect of Poor Sleep Quality and Excessive Daytime Sleepiness on Factors Associated With Diabetes Self-Management

摘要

Purpose The purpose of this study is to investigate the association of impaired sleep quality and daytime sleepiness on selfreported diabetes control and psychological and social factors that affect diabetes self-management. Methods Participants were 107 adults with type 2 diabetes (T2DM) with self-reported daytime sleepiness. Subjective sleepiness was assessed using the Epworth Sleepiness Scale (ESS); sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Global score and its 3 factors of Perceived Sleep Quality, Sleep Efficiency, and Daily Disturbances. The Diabetes Care Profile (DCP) scales (Control Problems, Social and Personal Factors, Positive Attitude, Negative Attitude, Self-Care Adherence, and Diet Adherence) were used to measure difficulty in maintaining glycemic control and factors important for diabetes control. Results Poor sleep quality was associated with significantly worse scores on the DCP scales, with lower diabetes control, negative attitude, decreased positive attitude, lower self-care adherence, and decreased adherence to dietary adherence. Hierarchal linear regression modeling revealed no significant associations between diabetes control problems and age, education, gender, and daytime sleepiness. Being married or partnered significantly decreased glycemic control problems, whereas poor sleep quality increased diabetes control problems. Further examination of PSQI factors (perceived sleep quality, sleep efficiency, and daily disturbances) found that being married or partnered significantly decreased diabetes control problems, whereas of the 3 factors of the PSQI, only the Daily Disturbances factor was significantly associated with increased diabetes control problems. Conclusions Impaired sleep quality and daytime sleepiness are associated with decreased diabetes self-management in adults with T2DM.