661 Chronotype, Mood, and Diabetes-Related Distress in Adults with Type 2 Diabetes

Abstract

Abstract Introduction Chronotype refers to an individual’s preferred timing of sleep and wakefulness, which can be classified as ‘normal’ or ‘late’ chronotypes. The purpose of this study was to examine whether late sleep timing was associated with impaired mood and diabetes-related distress in persons with type 2 diabetes (T2D). Methods The study is a secondary analysis of pooled cross-sectional baseline data from two studies of treatment of obstructive sleep apnea (R01-DK96028) and insomnia (K24-NR016685) in persons with T2D. Sleep timing was measured by the bedtime from a 7-day sleep diary. “Normal” sleep timing was defined as bedtime between 9PM to 12AM ≥ 85% per week. “Late” sleep timing as bedtime after 12AM with normal sleep timing < 85% per week. Other sleep variables evaluated were sleep duration, daytime sleepiness (Epworth Sleepiness Scale [ESS]), and OSA severity (apnea-hypopnea index [AHI]). The Profiles of Mood States measured Total Mood Disturbance (TMD) and the subscales of Tension-Anxiety (T-A), Depression-Dejection (D-D), Anger-Hostility (A-H), Vigor-Activity (V-A), Fatigue-Inertia (F-I), and Confusion-Bewilderment (C-B). Diabetes-related distress was measured by the Problem Areas in Diabetes (PAID). Hierarchical multiple regression was performed to determine whether sleep timing was associated with mood and diabetes-related distress. Results The sample (N=296) had 61% with late sleep timing (n=181). Persons with normal vs late sleep timing were similar in age, sex, race, and education (p >.05). Persons with late sleep timing were less likely to be partnered, had shorter sleep duration and greater mood impairment (TMD and T-A, D-D, A-H, C-B subscales) than those with normal timing (all p values <.05); there was no significant difference by sleep timing in PAID scores (p=.256). Hierarchical regression analyses adjusting for demographics (age, sex, race, marital status, education level), clinical (HbA1c, BMI), and sleep variables (sleep duration, ESS, AHI) revealed that late sleep timing was not significantly associated with impaired mood (TMD and subscales) or PAID. However, ESS was statistically significant in predicting greater TMD (β=.310, p <.001), mood subscales (all p-values <.05) and PAID (β =.222, p <.001). Conclusion Daytime sleepiness, not late sleep timing, is a significant sleep-related symptom for increased mood impairment and diabetes-related distress in persons with T2D. Support (if any):