Age-Related Differences in Mood, Diabetes-Related Distress, and Functional Outcomes in Adults With Type 2 Diabetes Mellitus and Comorbid Obstructive Sleep Apnea and Insomnia

Overview

Journal Diabetes Educ

Publisher Sage Publications

Specialties Endocrinology
Nursing

Date 2020 Sep 19

PMID 32948109

Citations 1

Authors

Bomin Jeon

Susan M Sereika

Judith A Callan

Faith S Luyster

Monica M DiNardo

Eileen R Chasens

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to examine age-related differences in mood, diabetes-related distress, and functional outcomes in activities sensitive to impaired sleep in adults with type 2 diabetes mellitus (T2DM) and comorbid obstructive sleep apnea (OSA) and insomnia. This study also evaluated the associations of age, insomnia severity, and OSA severity on outcome variables.

Methods: This study was a secondary analysis of pooled baseline data from 2 randomized controlled trials among adults with T2DM with symptoms of sleep disorders (N = 145,109 younger adults, 36 older adults; 46.2% male; 67.6% white). Comorbid OSA and insomnia was defined as Apnea-Hypopnea Index ≥5 events per hour and Insomnia Severity Index ≥10. Outcome variables included mood, diabetes-related distress, and functional outcomes.

Results: Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all s < .05). Insomnia severity was associated with worse mood ( = 2.59, < .001) and diabetes-related distress ( = 1.40, < .001) and lower functional outcome ( = -0.22, < .001). Older age was associated with lower diabetes-related distress ( = -0.44, = .040).

Conclusion: Older age was a protective factor of mood disturbance, diabetes-related distress, and functional impairment in adults with T2DM and comorbid OSA and insomnia. Insomnia severity was associated with greater mood disturbance, diabetes-related distress, and functional impairment when OSA and insomnia coexist. The results suggest that diabetes care and education specialists should assess patients for impaired sleep.

Citing Articles

Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005-2018 data.

Feng Z, Tong W, Zhang X, Tang Z BMC Psychiatry. 2023; 23(1):490.

PMID: 37430235 PMC: 10331954. DOI: 10.1186/s12888-023-04999-z.

References

Polonsky W, Anderson B, Lohrer P, Welch G, Jacobson A, Aponte J . Assessment of diabetes-related distress. Diabetes Care. 1995; 18(6):754-60. DOI: 10.2337/diacare.18.6.754. View

Gupta S, Wang Z . Predictors of sleep disorders among patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2016; 10(4):213-220. DOI: 10.1016/j.dsx.2016.06.009. View

Berry R, Budhiraja R, Gottlieb D, Gozal D, Iber C, Kapur V . Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012; 8(5):597-619. PMC: 3459210. DOI: 10.5664/jcsm.2172. View

Gooneratne N, Gehrman P, Nkwuo J, Bellamy S, Schutte-Rodin S, Dinges D . Consequences of comorbid insomnia symptoms and sleep-related breathing disorder in elderly subjects. Arch Intern Med. 2006; 166(16):1732-8. DOI: 10.1001/archinte.166.16.1732. View

Buysse D, Hall M, Strollo P, Kamarck T, Owens J, Lee L . Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample. J Clin Sleep Med. 2008; 4(6):563-71. PMC: 2603534. View

Young T, Shahar E, Nieto F, Redline S, Newman A, Gottlieb D . Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002; 162(8):893-900. DOI: 10.1001/archinte.162.8.893. View

Denton E, Barnes M, Churchward T, Jackson M, Collins A, Naughton M . Mood disorders are highly prevalent in patients investigated with a multiple sleep latency test. Sleep Breath. 2017; 22(2):305-309. DOI: 10.1007/s11325-017-1572-8. View

Welch G, Jacobson A, Polonsky W . The Problem Areas in Diabetes Scale. An evaluation of its clinical utility. Diabetes Care. 1997; 20(5):760-6. DOI: 10.2337/diacare.20.5.760. View

Fisher L, Gonzalez J, Polonsky W . The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision. Diabet Med. 2014; 31(7):764-72. PMC: 4065190. DOI: 10.1111/dme.12428. View

10.

Charles S . Strength and vulnerability integration: a model of emotional well-being across adulthood. Psychol Bull. 2010; 136(6):1068-91. PMC: 3059514. DOI: 10.1037/a0021232. View

11.

Farajzadeh M, Hosseini M, Mohtashami J, Chaibakhsh S, Tafreshi M, Gheshlagh R . The Association Between Obstructive Sleep Apnea and Depression in Older Adults. Nurs Midwifery Stud. 2016; 5(2):e32585. PMC: 5002089. DOI: 10.17795/nmsjournal32585. View

12.

Einhorn D, Stewart D, Erman M, Gordon N, Philis-Tsimikas A, Casal E . Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract. 2007; 13(4):355-62. DOI: 10.4158/EP.13.4.355. View

13.

Gibson S . The measurement of mood states in older adults. J Gerontol B Psychol Sci Soc Sci. 1997; 52(4):P167-74. DOI: 10.1093/geronb/52b.4.p167. View

14.

Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T . How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment. Diabetologia. 2006; 49(3):469-77. DOI: 10.1007/s00125-005-0094-2. View

15.

Ong J, Crisostomo M . The more the merrier? Working towards multidisciplinary management of obstructive sleep apnea and comorbid insomnia. J Clin Psychol. 2013; 69(10):1066-77. PMC: 3766499. DOI: 10.1002/jclp.21958. View

16.

Johns M . Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest. 1993; 103(1):30-6. DOI: 10.1378/chest.103.1.30. View

17.

Lichstein K, Riedel B, Lester K, Aguillard R . Occult sleep apnea in a recruited sample of older adults with insomnia. J Consult Clin Psychol. 1999; 67(3):405-10. DOI: 10.1037//0022-006x.67.3.405. View

18.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

19.

Berg C, Upchurch R . A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychol Bull. 2007; 133(6):920-54. DOI: 10.1037/0033-2909.133.6.920. View

20.

Jeong M, Reifsnider E . Associations of Diabetes-Related Distress and Depressive Symptoms With Glycemic Control in Korean Americans With Type 2 Diabetes. Diabetes Educ. 2018; 44(6):531-540. DOI: 10.1177/0145721718807443. View