Association of sleep quality with type 2 diabetes mellitus

Abstract

Objective To explore the association between sleep quality and the increasing risk of type 2 diabetes mellitus (T2DM). Methods A total of 771 patients aged 25-70 years living in Xuzhou City of Jiangsu Province for at least 5 years were enrolled for the survey of risk factor related noninfectious chronic disease in 2013. In this investigation, those who suffered from other types of diabetes, neuropathy, other endocrine disease, cardiovascular, renal and hepatic dysfunction, dyspnea or cancer were excluded. To reduce the influence of confounding factors, another 771 participants were enrolled as controls. Each case was arranged to have a control who was matched in age (difference not more than 3 years), gender, residence and family history. All the participants were interviewed with self-designed questionnaire, and sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI) questionnaire. Student's t test, Chi-square and multivariate logistic regression were used for data analysis. Results The PSQI score in the T2DM patients vs. the controls were 5.15±2.40 vs. 2.71±1.93 (t=21.96, P<0.01). The scores of sleep-related factors, including subjective poor sleep quality, bedtime resistance, short sleep duration, sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction, of the T2DM patients were higher than those of the controls. The proportion of sleep related behaviors of the T2DM patients was higher, except for early awakening, cold feeling and nightmare. Poor sleep quality was associated with the increasing risk of T2DM (odds ratio 2.06, 95% CI 1.69-2.52). In multivariate logistic regression, when adjusted for confounding factors, the risk of T2DM was still increased (odds ratio 1.72, 95% CI 1.62-1.83). Sleep-related factors (e.g. subjective poor sleep quality, bedtime resistance, short sleep duration, sleep efficiency and sleep disturbance) were correlated with the risk of T2DM (odds ratio was 3.34, 1.63, 1.10, 1.87 and 3.89, respectively). Conclusion Low quality of sleep may be strongly associated with an increased risk of T2DM. Key words: Diabetes mellitus, type 2; Sleep initiation and maintenance disorders; Risk factors; Case-control studies