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Association of the combination of sleep duration and sleep quality with quality of life in type 2 diabetes patients

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Abstract

Purpose

Sleep problems are very common in people with diabetes. The aim of this study was to assess the association of the combination of self-reported sleep duration and sleep quality on quality of life (QOL) in Chinese patients with type 2 diabetes mellitus (T2DM).

Methods

We analyzed the community-based cross-sectional data of 798 patients with T2DM in Xiamen, China, in 2016. Sleep duration was measured as self-reported average sleep time during the previous month. Sleep quality was evaluated as self-rated reports. QOL was assessed by the Diabetes-specific Quality of Life (DSQL), with scores < 40 and ≥ 80 set as cut-off values for differentiating good, fair, and poor QOL. Ordinal logistic regression was performed to model the associations of QOL with sleep duration, sleep quality, and their combined effects by adjusting for certain covariates.

Results

The separate associations of sleep duration and sleep quality in relation to QOL in T2DM patients were significant (P < 0.05). After controlling for sleep quality, there was no significant correlation between sleep duration and QOL. The combined analysis suggested that the association of sleep duration with QOL in T2DM patients was sleep quality-dependent. Longer sleep duration was associated with higher odds ratios (ORs) of better QOL for patients who reported fair sleep quality and good sleep quality, but no such trend was observed for patients who reported poor sleep quality (P> 0.05). Excessive sleep duration (≥ 9 h per day) was detrimental to QOL in T2DM only when they reported poor sleep quality.

Conclusions

Specific disparities exist in the association of sleep quality with sleep duration and QOL in T2DM patients. Failures to take into account the effect of sleep quality when evaluating the impact of sleep on QOL significantly bias the results. It is important to integrate duration and quality of sleep as a composite sleep index when assessing sleep of patients with T2DM.

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Acknowledgements

Ethical approval was obtained from the ethical review committee of the School of Public Health, Xiamen University. This study was supported by the Center for Health Economics and Policy at the School of Public Health, Xiamen University, the Youth Project of National Natural Science Fund (No. 71403229), and the project of Natural Science Fund of Fujian Province (No. 2017J01133). All funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, China

    Yanbing Zeng, Jielong Wu, Jiahui Yin, Jia Chen & Ya Fang

  2. Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang’an Nan Road, Xiang’an District, Xiamen, Fujian, 361102, China

    Yanbing Zeng, Jielong Wu, Jiahui Yin, Jia Chen & Ya Fang

  3. Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Zhen Hai Road, Si Ming District, Xiamen, Fujian, 361003, China

    Shuyu Yang

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  1. Yanbing Zeng
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Correspondence to Ya Fang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Zeng, Y., Wu, J., Yin, J. et al. Association of the combination of sleep duration and sleep quality with quality of life in type 2 diabetes patients. Qual Life Res 27, 3123–3130 (2018). https://doi.org/10.1007/s11136-018-1942-0

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