A comparison of glycemic control, sleep, fatigue, and depression in type 2 diabetes with and without restless legs syndrome.
OBJECTIVE
The purpose of this pilot study was to determine how sleep quality, glycemic control, sleepiness, fatigue, and depression differ in persons with type 2 diabetes with and without restless legs syndrome (RLS). RESEARCH DESIGNS/METHODS: The design was a descriptive, case-control study of participants with type 2 diabetes with and without RLS at the University of Pennsylvania, Rodebaugh Diabetes Center. Thirty-nine participants (adults over 21 years of age who had been diagnosed with type 2 diabetes and had a HbA1c in the last 3 months) were stratified based on RLS diagnostic criteria. Exclusion criteria included severe hypoglycemia identified by seizures or coma related to hypoglycemia or known sleep disorder other than RLS. The primary outcome of sleep was measured by self-report sleep quality (Pittsburgh Sleep Quality Index) with secondary outcomes including HbA1c, sleepiness (Epworth Sleepiness Scale), fatigue (Fatigue Severity Scale), and depression (Center for Epidemiologic Studies-Depression Scale).


RESULTS
Participants with type 2 diabetes with RLS reported a significant difference in quality of sleep (p = .001), sleep latency (p = .04), sleep efficiency (p = .035), use of sleep medications (p < .001), and daytime dysfunction (p = .005). In the total group, higher HbA1c levels were positively correlated with sleepiness (p = 038). Global Pittsburgh Sleep Quality Index scores were positively correlated with fatigue (r = .58, p = .002) and depression (r =.74, p < .001). As well, fatigue and sleepiness were positively correlated (r = .36, p = .04).


CONCLUSIONS
RLS is a significant sleep disorder that may have an impact on diabetes management and health outcomes. More research should be conducted on the impact of RLS in sleep to improve diabetic management.
Cuellar
Norma G
NG
University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA. ncuellar@nursing.upenn.edu
Ratcliffe
Sarah J
SJ
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D015897:Comorbidity; D003863:Depression / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D005221:Fatigue / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D010865:Pilot Projects; D012148:Restless Legs Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin