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Is insomnia severity a moderator of the associations between obstructive sleep apnea severity with mood and diabetes-related distress?

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

This study examined insomnia severity as a moderator of the associations between obstructive sleep apnea (OSA) severity with impaired mood and diabetes-related distress in adults with OSA and type 2 diabetes (T2D).

Methods

This secondary analysis used pooled baseline data from two randomized controlled trials that evaluated the efficacy of treatment of OSA or insomnia in adults with T2D. Participants for this analysis had OSA (Apnea Hypopnea Index [AHI] ≥ five events/hour obtained from an in-home sleep apnea testing device) and completed questionnaires on insomnia, mood, and diabetes-related distress. Hierarchical multiple linear regression and multivariate linear regression analyses were used controlling for demographic characteristics and restless leg syndrome.

Results

Of 240 participants, mean age was 57.8 ± 10.17, 50% were female, and 35% were non-White. Participants had poorly controlled diabetes (Mean HbA1C = 7.93 ± 1.62), and moderate OSA (Mean AHI = 19.3 ± 16.2). Insomnia severity significantly moderated the association between OSA severity and mood (b = -0.048, p = .017). Although insomnia severity did not moderate the relationship between OSA severity and diabetes-related distress (b = -0.009, p = .458), insomnia severity was independently associated with greater diabetes-related distress (b = 1.133, p < .001).

Conclusions

In adults with T2D and OSA, as insomnia severity increased, increasing OSA severity was associated with lower level of mood disturbances. Insomnia independently increased the level of diabetes-related distress. These findings suggest that comorbid insomnia may be more impactful than OSA on increasing mood disturbances and diabetes-related distress in adults with T2D.

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Data availability

Data will be made available on reasonable request.

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Acknowledgements

This study is part of a doctoral dissertation from the University of Pittsburgh. The doctoral dissertation was published on http://d-scholarship.pitt.edu/42773/1/bomin_jeon_phd_etdfinal.pdf.

Funding

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (Chasens; R01-DK096028) and the National Institute of Nursing Research (Chasens; K24-NR016685). This research was also supported through Clinical Translational Science Institute at the University of Pittsburgh Grant Numbers UL1- RR024153 and UL1-TR000005.

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Authors and Affiliations

  1. University of Iowa College of Nursing, 50 Newton Road, Iowa City, IA, 52242, USA

    Bomin Jeon

  2. University of Pittsburgh School of Nursing, Pittsburgh, PA, USA

    Eileen R. Chasens, Faith S. Luyster, Judith A. Callan, Monica M. DiNardo & Susan M. Sereika

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  1. Bomin Jeon
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  2. Eileen R. Chasens
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  3. Faith S. Luyster
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  6. Susan M. Sereika
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Contributions

All authors contributed to the study conception and design. Data analysis and investigation were performed by Bomin Jeon and Susan M. Sereika. The first draft of the manuscript was written by Bomin Jeon, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bomin Jeon.

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Ethics approval

This study was approved by exemption from the University of Pittsburgh Institutional Review Board (IRB) because it was categorized as secondary research on an existing dataset (STUDY19100353).

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This study was a secondary analysis using existing dataset and formal consent was not required.

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Jeon, B., Chasens, E.R., Luyster, F.S. et al. Is insomnia severity a moderator of the associations between obstructive sleep apnea severity with mood and diabetes-related distress?. Sleep Breath 27, 1081–1089 (2023). https://doi.org/10.1007/s11325-023-02819-y

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