Subjective sleep impairment in adults with type 1 or type 2 diabetes: Results from Diabetes MILES--The Netherlands.
OBJECTIVE
Despite growing recognition of the impact of sleep on diabetes, a clear profile of people with diabetes regarding subjective sleep impairment has yet to be established. This study examines: (1) subjective sleep characteristics in adults with type 1 and type 2 diabetes; (2) the relationship of poor subjective sleep quality with glycaemic control, self-care and daytime functioning; (3) possible risk markers for poor sleep quality.


METHODS
In a cross-sectional study, Dutch adults with type 1 (n=267) or type 2 diabetes (n=361) completed an online survey, including the Pittsburgh Sleep Quality Index (PSQI), socio-demographic, clinical, self-care and psychological measures.


RESULTS
Poor sleep quality (PSQI-score >5) was reported by 31% of adults with type 1 and 42% of adults with type 2 diabetes. Participants with good and poor sleep quality did not differ in self-reported HbA1c or the frequency of meeting lifestyle recommendations. Poor sleep quality was related to a higher self-care burden and higher levels of daytime sleepiness, fatigue, depressive and anxiety symptoms, and diabetes-specific distress. In multivariable logistic regression analyses examining risk markers, poor sleep quality was associated with depressive symptoms in adults with type 1 (OR=1.39, 95% CI 1.25-1.54) and type 2 diabetes (OR=1.31, 1.16-1.47), and with being female in those with type 2 diabetes (OR=2.72, 1.42-5.20).


CONCLUSIONS
Poor subjective sleep quality is prevalent both in adults with type 1 and type 2 diabetes, and is related to poor daytime functioning and higher self-care burden. The temporal relation with depression and merits of therapy should be explored.
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, Tilburg, 5000 LE, The Netherlands. Electronic address: g.m.nefs@tilburguniversity.edu.
Giesje
G
Nefs
Department of Internal Medicine, St. Elisabeth Hospital, PO Box 90151, Tilburg, 5000 LC, The Netherlands.
Esther
E
Donga
Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, Amsterdam, 1105 BA, The Netherlands; Departments of Integrative Neurophysiology and Medical Psychology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands.
Eus
E
van Someren
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, Tilburg, 5000 LE, The Netherlands; Department of Psychiatry, VU University Medical Center and EMGO Institute for Health and Care Research, A.J. Ernststraat 1187, Amsterdam, 1081 HL, The Netherlands.
Mariska
M
Bot
The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia, Vic, 570 Elizabeth Street, Melbourne, Victoria, 3000, Australia; Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; AHP Research, 16 Walden Way, Hornchurch, UK.
Jane
J
Speight
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, Tilburg, 5000 LE, The Netherlands.
François
F
Pouwer
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000502:physiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000097:blood / Q000453:epidemiology*; D013315:Stress, Psychological / Q000097:blood / Q000453:epidemiology
D001786:Blood Glucose
Diabetes; Emotional distress; Fatigue; Glycaemic control; Self-care; Sleep quality