PLoS ONE (Jan 2018)

Association of usual sleep quality and glycemic control in type 2 diabetes in Japanese: A cross sectional study. Sleep and Food Registry in Kanagawa (SOREKA).

  • Rika Sakamoto,
  • Tadashi Yamakawa,
  • Kenichiro Takahashi,
  • Jun Suzuki,
  • Minori Matsuura Shinoda,
  • Kentaro Sakamaki,
  • Hirosuke Danno,
  • Hirohisa Tsuchiya,
  • Manabu Waseda,
  • Tatsuro Takano,
  • Fuyuki Minagawa,
  • Masahiko Takai,
  • Tomohide Masutani,
  • Jo Nagakura,
  • Erina Shigematsu,
  • Masashi Ishikawa,
  • Shigeru Nakajima,
  • Kazuaki Kadonosono,
  • Yasuo Terauchi

DOI
https://doi.org/10.1371/journal.pone.0191771
Journal volume & issue
Vol. 13, no. 1
p. e0191771

Abstract

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Excessively short and long sleep durations are associated with type 2 diabetes, but there is limited information about the association between sleep quality and diabetes. Accordingly, the present study was performed to investigate this relationship.The subjects were 3249 patients with type 2 diabetes aged 20 years or older. Sleep quality was assessed by using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates worse sleep quality, and a global PSQI score >5 differentiates poor sleepers from good sleepers.The mean global PSQI score was 5.94 ± 3.33, and 47.6% of the patients had a score of 6 or higher. Regarding the components of the PSQI, the score was highest for sleep duration, followed by subjective sleep quality and then sleep latency in decreasing order. When the patients were assigned to HbA1c quartiles (≤ 6.5%, 6.6-7.0%, 7.1-7.8%, and ≥ 7.9%), the top quartile had a significantly higher global PSQI score than the other quartiles. The top HbA1c quartile had a sleep duration of only 6.23 ± 1.42 hours, which was significantly shorter than in the other quartiles. Also, sleep latency was 25.3 ± 31.8 minutes in the top quartile, which was significantly longer (by approximately 20 minutes) than in the other quartiles. When analysis was performed with adjustment for age, gender, BMI, smoking, and other confounders, the global PSQI score was still significantly higher and sleep duration was shorter in the top HbA1c quartile (HbA1c ≥ 7.9%).Japanese patients with type 2 diabetes were found to have poor subjective sleep quality independently of potential confounders, especially those with inadequate glycemic control. Impairment of sleep quality was associated with both increased sleep latency and a shorter duration of sleep.