Relationship and Variation of Diabetes Related Symptoms, Sleep Disturbance and Sleep-related Impairment in Adults with Type 2 Diabetes

Aim: The objective of this study was to examine whether diabetes-related symptoms (e.g. fatigue, neuropathic pain, diabetes distress and depressive symptoms) were related to sleep disturbance and sleep-related impairment in adults with type 2 diabetes while controlling for potential covariates.

Background: In people with type 2 diabetes, sleep disturbance and sleep-related impairment are common and likely associated with diabetes-related symptoms. However, limited research has investigated the predictive ability of diabetes-related symptoms on sleep.

Design: A correlational, cross-sectional design was used.

Methods: Data were collected at a large university in the Midwestern United States from September 2013-March 2014. Multiple linear regression analyses were used to examine the relationship of diabetes-related symptoms (fatigue, neuropathic pain, distress and depressive symptoms) to sleep disturbance and sleep-related impairment. The instruments included Patient-Reported Outcomes Measurement Information System instruments, Diabetes Symptom Checklist and Diabetes Distress Scale.

Findings: In this study of adults with type 2 diabetes (N = 90; 52.2% female, mean age 57.4 years), gender, A1C, neuropathic pain and fatigue were significantly related to sleep disturbance when age, diabetes duration, depressive symptoms and distress were controlled. Those variables collectively explained 52% of the variation in sleep disturbance. Fatigue was significantly associated with sleep-related impairment when the same covariates were controlled.

Conclusion: Findings suggested that diabetes-related symptoms, including neuropathic pain and fatigue, are strongly related to sleep disturbance and sleep-related impairment in adults with type 2 diabetes, underscoring the need to include detailed assessments of neuropathic pain and fatigue when evaluating sleep.