Diabetes distress and sleep impairment in type 2 diabetes: A population-based cross-sectional study-The HUNT Study, Norway.

Aims: To examine associations between sleep impairments and diabetes distress in men and women with type 2 diabetes (T2D) by using cross-sectional data from the Trøndelag Health Study (HUNT).

Methods: This population-based cross-sectional study consists of individuals ≥20 years with T2D participating in the HUNT4 survey (2017-2019; n = 1954). Sleep impairments (snoring, sleep apnoea, troubles falling asleep, wake up during the night, early wakening, difficulties coping during the daytime due to sleep problems and restless legs) were measured by the sleeping HUNT-Questionnaire, along with a separate question on the number of hours of sleep at night. Diabetes distress was measured using the Problem Areas in Diabetes (PAID-5) questionnaire. Diabetes distress prevalence, grouped by sleep impairment, was estimated with 95% confidence intervals. Multivariable linear regression models with distress as outcome and adjusted for demographic, clinical and mental health factors were used to examine associations with sleep.

Results: Overall, sleep impairment was associated with increased diabetes distress. Regression coefficients B (95% CI) for higher distress score were 0.6 (95% CI 0.2, 0.9) for ≤7 h of sleep, 0.6 (95% CI 0.1-1.1) for snoring, 1.4 (95% CI 0.8-2.2) for troubles falling asleep, 1.1 (95% CI 0.6-1.6) for waking up during the night, 1.2 (95% CI 0.7-1.8) for early wakening, 2.6 (95% CI 1.7-3.6) for troubles coping during daytime due to sleep problems and 0.8 (95% CI 0.2-1.3) for restless legs.

Conclusion: Multiple components of sleep impairment were significantly associated with high diabetes distress in individuals with T2D.