A cross-sectional study on the sleep quality among type 2 diabetes mellitus patients and its associated factors

Poor sleep quality is common among patients with type 2 diabetes mellitus (T2DM). It has detrimental effects on physical and psychological health, as well as on quality of life. This study aimed to determine the prevalence of poor sleep quality among T2DM patients and to investigate the factors associated with this disorder.

A cross-sectional study was conducted at Klinik Kesihatan Seremban in Seremban district, Negeri Sembilan. Data were collected using the Malay version of the Pittsburgh Sleep Quality Index (PSQI-M) with a cut-off point of >5 as poor sleep quality. The Depression Anxiety Stress Scale-21 (DASS-21) was used to measure level of psychological distress. Data were collected between July 2022 until January 2023.

A total of 319 patients with T2DM participated. Their mean age was 63 (11) years, 58% were women and 42.9% were of Indian ethnicity. The mean total score of PSQI was 4.04 (2.21) and 23% of the participants had poor sleep quality. Multivariate logistic regression analysis revealed that poor sleep quality was significantly associated with Indian ethnicity (Adj. OR = 2.25; 95%CI: 1.05, 4.82; p = 0.037), separated or widowed (Adj. OR = 2.16; 95%CI = 1.15, 4.05; p = 0.016), having nocturia (Adj. OR = 2.13; 95%CI = 1.18, 3.84; p = 0.012) and depressive symptoms (Adj. OR = 3.41; 95%CI: 1.01, 11.48; p = 0.048).

Poor sleep quality was prevalent in almost a quarter of T2DM patients studied. Indian ethnicity, separated or widowed, having nocturia, and depressive symptoms were independently associated with poor sleep quality. Despite lower prevalence of poor sleep quality compared to other studies, identification of those at higher risk warrants further exploration in lifestyle management of patients with T2DM.