Role of Sleep Disturbances and Diabetes-Related Distress on Glycemic Control: A Path Analysis

Area of Science:

• Endocrinology
• Sleep Medicine
• Psychiatry

Background:

• Type 2 diabetes (T2D) management is challenging, with many patients failing to achieve optimal glycemic control.
• Sleep disorders, including obstructive sleep apnea (OSA) and insomnia, are prevalent in T2D and associated with poorer glucose regulation.
• Insomnia, especially with short sleep duration, may exacerbate glycemic control issues by increasing diabetes-related distress.

Purpose of the Study:

• To investigate the relationship between sleep duration, insomnia severity, diabetes-related distress, and glycemic control in adults with T2D.
• To evaluate the mediating role of insomnia severity and diabetes-related distress in the association between sleep duration and glycemic control.

Main Methods:

• Path analysis was performed on data from 237 adults with T2D and OSA from two parent studies (DSTT and DSTT-I).
• Sleep duration was measured using the Pittsburgh Sleep Quality Index.
• Insomnia severity was assessed with the Insomnia Severity Index, and diabetes-related distress with the Problem Areas in Diabetes scale.
• Glycemic control was determined by hemoglobin A1c levels.

Main Results:

• Shorter sleep duration was found to indirectly worsen glycemic control.
• This effect was mediated by increased insomnia severity, which subsequently elevated diabetes-related distress.
• These associations remained significant after controlling for OSA severity and various demographic and socioeconomic factors.

Conclusions:

• Sleep duration is a potential modifiable factor influencing insomnia severity, diabetes-related distress, and glycemic control in T2D.
• Targeting sleep duration optimization within clinical diabetes management could be a strategy to improve glucose regulation.
• Addressing sleep issues may be crucial for enhancing overall diabetes care and outcomes.