2.50
Hdl Handle:
http://hdl.handle.net/10755/621501
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Insomnia and Health-Related Quality of Life in Adults With Type 2 Diabetes
Other Titles:
Chronic Illness Management
Author(s):
Sereika, Susan; Chasens, Eileen R.; Graves, Letitia Y.
Lead Author STTI Affiliation:
Non-member
Author Details:
Susan Sereika, PhD, Professional Experience: Susan M. Sereika, PhD, is a Professor in the Department of Health and Community Systems in the School of Nursing with secondary appointments in the Departments of Biostatistics and Epidemiology at the Graduate School of Public Health and the Clinical Translational Science Institute, and is the Director of the Center for Research and Evaluation at the University of Pittsburgh School of Nursing. She is a Co-I on the R01 grant (5R01-DK096028-04). Author Summary: Dr. Sereika's area of research is statistics. The area of statistics that particularly interests her is the modeling and assessment of longitudinal data. She has collaborated as a co-investigator and statistician on a number of research projects with either intramural or extramural funding in the health sciences, many of which have targeted regimen adherence using multiple modes of monitoring.
Abstract:

Purpose: Previous research that suggests that obstructive sleep apnea (OSA) is associated with an increased risk for T2DM(Aronsohn, Whitmore, Van Cauter, &, Tasali, 2010) as well as decreased health-related quality of life (HRQoL) in persons with diabetes (Chasens, Sereika, Burke, Strollo, & Korytkowski, 2014). Diabetes increases the risk for another sleep disorder, insomnia, in a dose-related fashion (Budhiraja, Roth, Hudgel, Budhiraja, P. & Drake, 2011). The purpose of this study is to evaluate if insomnia is associated with worse HRQoL in adults with T2DM.

Methods: This study is a secondary analysis of baseline data from participants in a randomized clinical trial (1R01DK096028). The parent study evaluates if persons with treatment of OSA + diabetes education have better glucose control and self-management behavior compared to those on a sham (placebo) device + diabetes education. Inclusion criteria for the baseline assessment include age > 18 years; self-report of T2DM, CPAP naïve, and willing to be randomized to CPAP if found to have OSA (apnea + hypopnea index [AHI] ≥ 10). Measures included demographics (sex, age, race, education), sleep quality (Pittsburgh Sleep Quality Index [PSQI] Buysse, Reynolds, Monk, Berman, Kupfer, 1989), (scores>5=poor sleep quality), insomnia (Insomnia Severity Index [ISI] Morin, Belleville, Belanger, Ivers, 2011); scores 0-14 = “no insomnia” to “mild insomnia” and scores ≥ 15 =“moderate insomnia” to “severe insomnia”), diabetes related distress (Problem Areas in Diabetes [PAID], Welch, Jacobson, Polonsky, 1997) with higher scores = more distress, and mental and physical HRQoL component scores (SF-12v2 MCS, PCS, Ware, Kosinski, Keller, Ware, Kosinski, Keller, 1996).) with higher scores = better mental or physical HRQoL. The clinical evaluation included A1C for glycemic control; height and weight were measured to calculate BMI. Descriptive statistics include mean (SD) for continuous variables and percent and frequency for categorical variables. Inferential statistics included independent Students t-tests, and Pearson correlations. Linear multiple regression models were conducted to see if age, race, college education, BMI, diabetes related distress, or insomnia predicted mental and physical HRQoL (MCS, PCS). The level of statistical significance was set at p<.05

Results: The sample (N=194) was primarily middle age (mean age=56.8 years ±10.7 [range 26-88 years], overweight (mean BMI= 34.7 ±6.8), had suboptimal glucose control (mean A1c= 7.9% ±1.8), and moderate-to-severe insomnia (41%). Participants were well distributed by sex (male 46%; n=90), race (white 54%, n=105), and college graduate (31%, n=60). No differences were observed in mental or physical HRQoL (MCS, PCS) by sex, race, marital status; participants with a college education had significantly (p<.01) increased physical HRQoL. Age was significantly associated with improved mental HRQoL (r=.25, p<.01). Participants with moderate-severe insomnia had significantly worse diabetes related distress [PAID], lower mental and physical HRQoL (MCS, PCS) than those who reported no insomnia/mild insomnia (all p values <0.5). Using the enter method it was found that age, BMI, diabetes related distress and insomnia explain a significant amount of the variance in mental HRQoL (F=12.564, p<.001, R2=.296, R2 adjusted =.273). The regression model for physical HRQoL found that age, college graduate, BMI, and insomnia explained a significant amount (F=7.575,p<.001, R2=.202, R2adjusted =.176). Limitations to this study include the cross-sectional sample, secondary analysis design, relatively modest sample size, and that the sample might not be reflective of all persons with T2DM.

Conclusions:  Insomnia was highly prevalent in the recruited sample; insomnia was found to have significant negative impact on mental and physical HRQoL after controlling for age, race, education, BMI and diabetes-related distress. Future research is needed to determine if insomnia is associated with worse glucose control or diabetes self-management behavior.

Keywords:
Insomnia; Quality of Life; Sleep Quality
Repository Posting Date:
16-Jun-2017
Date of Publication:
16-Jun-2017
Other Identifiers:
INRC17H06
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleInsomnia and Health-Related Quality of Life in Adults With Type 2 Diabetesen_US
dc.title.alternativeChronic Illness Managementen
dc.contributor.authorSereika, Susanen
dc.contributor.authorChasens, Eileen R.en
dc.contributor.authorGraves, Letitia Y.en
dc.contributor.departmentNon-memberen
dc.author.detailsSusan Sereika, PhD, Professional Experience: Susan M. Sereika, PhD, is a Professor in the Department of Health and Community Systems in the School of Nursing with secondary appointments in the Departments of Biostatistics and Epidemiology at the Graduate School of Public Health and the Clinical Translational Science Institute, and is the Director of the Center for Research and Evaluation at the University of Pittsburgh School of Nursing. She is a Co-I on the R01 grant (5R01-DK096028-04). Author Summary: Dr. Sereika's area of research is statistics. The area of statistics that particularly interests her is the modeling and assessment of longitudinal data. She has collaborated as a co-investigator and statistician on a number of research projects with either intramural or extramural funding in the health sciences, many of which have targeted regimen adherence using multiple modes of monitoring.en
dc.identifier.urihttp://hdl.handle.net/10755/621501-
dc.description.abstract<p><strong><strong>Purpose: </strong></strong><span>Previous research that suggests that obstructive sleep apnea (OSA) is associated with an increased risk for T2DM</span><span>(Aronsohn, Whitmore, Van Cauter, &, Tasali, 2010) as well as decreased health-related quality of life (HRQoL) in persons with diabetes (Chasens, Sereika, Burke, Strollo, & Korytkowski, 2014). Diabetes increases the risk for another sleep disorder, insomnia, in a dose-related fashion (Budhiraja, Roth, Hudgel, Budhiraja, P. & Drake, 2011). The purpose of this study is to evaluate if insomnia is associated with worse HRQoL in adults with T2DM.</span></p> <p><strong>Methods: </strong>This study is a secondary analysis of baseline data from participants in a randomized clinical trial (1R01DK096028). The parent study evaluates if persons with treatment of OSA + diabetes education have better glucose control and self-management behavior compared to those on a sham (placebo) device + diabetes education. Inclusion criteria for the baseline assessment include age > 18 years; self-report of T2DM, CPAP naïve, and willing to be randomized to CPAP if found to have OSA (apnea + hypopnea index [AHI] ≥ 10). Measures included demographics (sex, age, race, education), sleep quality (Pittsburgh Sleep Quality Index [PSQI] Buysse, Reynolds, Monk, Berman, Kupfer, 1989), (scores>5=poor sleep quality), insomnia (Insomnia Severity Index [ISI] Morin, Belleville, Belanger, Ivers, 2011); scores 0-14 = “no insomnia” to “mild insomnia” and scores ≥ 15 =“moderate insomnia” to “severe insomnia”), diabetes related distress (Problem Areas in Diabetes [PAID], Welch, Jacobson, Polonsky, 1997) with higher scores = more distress, and mental and physical HRQoL component scores (SF-12v2 MCS, PCS, Ware, Kosinski, Keller, Ware, Kosinski, Keller, 1996).) with higher scores = better mental or physical HRQoL. The clinical evaluation included A1C for glycemic control; height and weight were measured to calculate BMI. Descriptive statistics include mean (SD) for continuous variables and percent and frequency for categorical variables. Inferential statistics included independent Students t-tests, and Pearson correlations. Linear multiple regression models were conducted to see if age, race, college education, BMI, diabetes related distress, or insomnia predicted mental and physical HRQoL (MCS, PCS). The level of statistical significance was set at <em>p</em><.05</p> <p><strong>Results: </strong>The sample (<em>N</em>=194) was primarily middle age (mean age=56.8 years ±10.7 [range 26-88 years], overweight (mean BMI= 34.7 ±6.8), had suboptimal glucose control (mean A1c= 7.9% ±1.8), and moderate-to-severe insomnia (41%). Participants were well distributed by sex (male 46%; <em>n</em>=90), race (white 54%, <em>n</em>=105), and college graduate (31%, <em>n</em>=60). No differences were observed in mental or physical HRQoL (MCS, PCS) by sex, race, marital status; participants with a college education had significantly (<em>p</em><.01) increased physical HRQoL. Age was significantly associated with improved mental HRQoL (<em>r</em>=.25, <em>p</em><.01). Participants with moderate-severe insomnia had significantly worse diabetes related distress [PAID], lower mental and physical HRQoL (MCS, PCS) than those who reported no insomnia/mild insomnia (all <em>p</em> values <0.5). Using the enter method it was found that age, BMI, diabetes related distress and insomnia explain a significant amount of the variance in mental HRQoL (<em>F</em>=12.564, <em>p</em><.001, <em>R</em><sup>2=</sup>.296, <em>R</em><sup>2</sup> adjusted =.273). The regression model for physical HRQoL found that age, college graduate, BMI, and insomnia explained a significant amount (<em>F</em>=7.575,<em>p</em><.001, <em>R</em><sup>2=</sup>.202, <em>R</em><sup>2</sup>adjusted =.176). Limitations to this study include the cross-sectional sample, secondary analysis design, relatively modest sample size, and that the sample might not be reflective of all persons with T2DM.</p> <p><strong>Conclusions: </strong> Insomnia was highly prevalent in the recruited sample; insomnia was found to have significant negative impact on mental and physical HRQoL after controlling for age, race, education, BMI and diabetes-related distress. Future research is needed to determine if insomnia is associated with worse glucose control or diabetes self-management behavior.</p>en
dc.subjectInsomniaen
dc.subjectQuality of Lifeen
dc.subjectSleep Qualityen
dc.date.available2017-06-16T14:13:47Z-
dc.date.issued2017-06-16-
dc.date.accessioned2017-06-16T14:13:47Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.