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

Abstract

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.

Consequences of Sleep Deprivation in Adult Diabetes Mellitus Type 2 Patients: An Integrative Review

“…Diabetes type 2 relevance. All relevant is English language 80% were from medical school education [1], [4], [9], [11], [13], [14], [17], [19], [20], [26], [27], [28], [42], [47], [53]., only 20% from nursing education [6], [10], [30], [46] . 1 and 2)…”

“…The age group ≥65 years competed with the age group <65 years (all Ps < 0.05). Older adults had expressively more distinctive marks on practical consequences delicate to reduced sleep (typical efficiency, social outcomes, activity, vigilance, and FOSQ total score; all Ps < 0.05) and no variance in the FOSQ subscale of affection and sexual relations [10]. Sleep affects hormones associated with tension, appetite, and glucose metabolism.…”

Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005–2018 data

“…Younger people with T2DM tend to be more vulnerable to depression due to their increased susceptibility to negative life events, such as being diagnosed with a chronic disease, which may lead to worse moods, more distress, and more depression than older adults [ 38 , 41 ]. Additionally, they may lack the coping skills and experience to effectively manage these situations and help reduce the perception of harmful consequences [ 7 ]. These findings suggest the importance of targeting depression screening and intervention efforts toward younger T2DM patients, in order to mitigate the potential negative impact of depression on their overall health outcomes.…”