Quality of sleep and risk for obstructive sleep apnoea in ambulant individuals with type 2 diabetes mellitus at a tertiary referral hospital in Kenya: a cross-sectional, comparative study

Abstract

BackgroundSleep disorders are common and associated with multiple metabolic and psychological derangements. Obstructive sleep apnoea (OSA) is among the most common sleep disorders and an inter-relationship between OSA, insulin resistance, obesity, type 2 diabetes (T2DM) and cardiovascular diseases has been established. Prevalence of sleep disorders in Kenyans, particularly in individuals with T2DM is unknown. We thus aimed to determine prevalence of poor quality of sleep (QOS) and high risk for OSA, among persons with T2DM and determine their associations with socio-demographic and anthropometric variables.MethodsUtilising a Cross- Sectional Descriptive design, QOS and risk for OSA were determined in a randomly selected sample of patients with T2DM (cases) and an age and sex matched comparison group. The validated Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) were used to measure QOS and risk for OSA respectively. Associations between poor QOS, high risk for OSA, and socio-demographic and anthropometric variables in cases were evaluated.ResultsFrom 245 randomly selected persons with T2DM attending outpatient clinics, aged over 18 years, 22 were excluded due to ineligibility thus 223 were included in the analysis; 53.8% were females, mean age was 56.8 (SD 12.2) years and mean BMI was 28.8 kg/m2 (SD 4.4). Among them, 119 (53%, CI 95% 46.5–60.2) had poor QOS and 99 (44% CI 95% 37.8–50.9) were at high risk for OSA. Among 112 individuals in comparison group, 33 (29.5%, CI 95% 20.9–38.3) had poor QOS and 9 (8%, CI 95% 3.3–13.4) had high risk for OSA. Cases had a significantly higher probability for poor QOS [OR 2.76 (95% CI 1.7–4.4))] and high risk for OSA [OR 9.1 (95% CI 4.4–19.0)].Higher waist circumference was independently associated with a high risk for OSA in cases.ConclusionsWe demonstrate a high burden of sleep disturbances in patients with T2DM. Our findings may have implications for clinicians to screen for sleep disorders when assessing patients with T2DM and warranting further attention by practitioners and researches in this field.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-017-0158-6) contains supplementary material, which is available to authorized users.

Outer Retinal Structure and Function Deficits Contribute to Circadian Disruption in Patients With Type 2 Diabetes

“…We also excluded patients with poor glycemic control, restless leg syndrome, and obstructive sleep apnea that can cause sleep disruption. 50,60 Pupil size and sleep quality reduces with increasing age, particularly above 65 years, 61 and both groups were age-matched to correct for the effect of age. Moreover, the analysis of the average baseline pupil diameter showed that it was not significantly different between groups.…”

Assessment of sleep quality and its predictors among patients with diabetes in Jazan, Saudi Arabia

“…It is estimated that 53.4% of diabetic patients experience a poor quality of sleep compared to 29% in general population. 8 Concerns over poor sleep quality among patients with diabetes have increased in recent years, but the implicated risk factors of poor sleep quality remain uncertain. Different factors that may affect the sleep quality of patients with diabetes have been suggested by many studies, including sociodemographic, clinical, and diabetes-related factors, such as duration of diabetes, diabetic complications, presence of comorbidity, 9 uncontrolled glycosylated hemoglobin, 10 abnormal body mass index (BMI), 11 insulin use, 12 and psychological factors.…”

Obstructive sleep apnea and obesity: implications for public health

“…4 OSA is strongly correlated with multiple disease conditions, including type 2 diabetes mellitus (T2DM), hyperlipidemia, hypertension, heart failure, cardiovascular diseases (CVD) and depression. 4,5…”