Bomin Jeon, Susan M Sereika, Judith A Callan, Faith S Luyster, Monica M DiNardo, Eileen R Chasens
{"title":"2型糖尿病合并阻塞性睡眠呼吸暂停和失眠的成年人情绪、糖尿病相关窘迫和功能结局的年龄相关差异","authors":"Bomin Jeon, Susan M Sereika, Judith A Callan, Faith S Luyster, Monica M DiNardo, Eileen R Chasens","doi":"10.1177/0145721720958396","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all <i>P</i>s < .05). Insomnia severity was associated with worse mood (<i>b</i> = 2.59, <i>P</i> < .001) and diabetes-related distress (<i>b</i> = 1.40, <i>P</i> < .001) and lower functional outcome (<i>b</i> = -0.22, <i>P</i> < .001). Older age was associated with lower diabetes-related distress (<i>b</i> = -0.44, <i>P</i> = .040).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":50584,"journal":{"name":"Diabetes Educator","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0145721720958396","citationCount":"3","resultStr":"{\"title\":\"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.\",\"authors\":\"Bomin Jeon, Susan M Sereika, Judith A Callan, Faith S Luyster, Monica M DiNardo, Eileen R Chasens\",\"doi\":\"10.1177/0145721720958396\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all <i>P</i>s < .05). Insomnia severity was associated with worse mood (<i>b</i> = 2.59, <i>P</i> < .001) and diabetes-related distress (<i>b</i> = 1.40, <i>P</i> < .001) and lower functional outcome (<i>b</i> = -0.22, <i>P</i> < .001). Older age was associated with lower diabetes-related distress (<i>b</i> = -0.44, <i>P</i> = .040).</p><p><strong>Conclusion: </strong>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. 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引用次数: 3
摘要
目的:本研究的目的是研究2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停(OSA)和失眠的成年人在情绪、糖尿病相关焦虑和对睡眠受损敏感活动的功能结局方面的年龄相关差异。本研究还评估了年龄、失眠严重程度和OSA严重程度对结果变量的影响。方法:本研究是对2项随机对照试验(N = 145,109名年轻人,36名老年人;男性46.2%;67.6%的白人)。以呼吸暂停-低通气指数≥5次/小时和失眠严重程度指数≥10为标准定义OSA与失眠合并症。结果变量包括情绪、糖尿病相关的痛苦和功能结果。结果:与年轻人相比,老年人报告了更好的情绪,更低的糖尿病相关痛苦和更高的功能结局(均p < 0.05)。失眠严重程度与较差的情绪(b = 2.59, P < .001)、糖尿病相关的焦虑(b = 1.40, P < .001)和较低的功能结局(b = -0.22, P < .001)相关。年龄越大,糖尿病相关焦虑越低(b = -0.44, P = 0.040)。结论:年龄是T2DM合并阻塞性睡眠呼吸暂停和失眠的成年人情绪障碍、糖尿病相关窘迫和功能损害的保护因素。当OSA和失眠共存时,失眠严重程度与更大的情绪障碍、糖尿病相关的痛苦和功能损害相关。研究结果表明,糖尿病护理和教育专家应该评估患者的睡眠受损情况。
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.
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 Ps < .05). Insomnia severity was associated with worse mood (b = 2.59, P < .001) and diabetes-related distress (b = 1.40, P < .001) and lower functional outcome (b = -0.22, P < .001). Older age was associated with lower diabetes-related distress (b = -0.44, P = .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.
期刊介绍:
The Diabetes Educator (TDE) is the official journal of the American Association of Diabetes Educators (AADE). It is a peer-reviewed journal intended to serve as a reference source for the science and art of diabetes management.
TDE publishes original articles that relate to aspects of patient care and education, clinical practice and/or research, and the multidisciplinary profession of diabetes education as represented by nurses, dietitians, physicians, pharmacists, mental health professionals, podiatrists, and exercise physiologists.