Association Between Sleep Quality and Health-related Quality of Life in Indian Type 2 Diabetes Mellitus Outpatients: Evidence from a Cross-sectional Study

Abstract

Objective: The objective of this study is to measure the relationship between sleep quality and health-related quality of life (HRQOL), in Indian population with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study, included total of 300 patients with T2DM. All participants were responding the sleep quality instruments (PSQI) and EQ-5D (HRQoL) questionnaires. A PSQI global score ≥5 was defined as poor sleep quality. The score of EQ-5D index ranges from - 0.111 to 1, where 1 represents preferred health. EQ-5D is visual analogue scale (VAS), determining the overall health status. Logistic regression analysis was used to examine the association between PSQI and EQ-5D. All the study data were analysed using the SPSS software version 20.0. Values of p <0.05 were considered statistically significant. Results: The mean age of participants were 57.56. Majority of the participants (55.3%) were identified as “poor sleepers” and female (31.3%) contributing higher proportion. Poor sleepers had significantly lower the HRQOL (p < 0.001). After adjustment, poor sleep quality was significantly associated with a lower HRQOL; EQ-5D index (OR= 1.080, 95%, CI: 1.015 - 1.148, p < 0.05), and EQ-5D VAS (OR= 1.092, 95%, CI: 1.021 - 1.176, p < 0.01). Overall the EQ-5D index and EQ-5D VAS were found to be an independent predictors of sleep quality. Conclusions: This study suggests that poor sleep quality is prevalent in Indian T2DM population, and it imparts a negative impact on HRQOL. Therefore, further studies are needed to determine the causal relationship between T2DM and measure of objective sleep and their impact on health.