Sleep disturbance in people with diabetes: A concept analysis

Zhu, Bingqian; Vincent, Catherine; Kapella, Mary C.; Quinn, Lauretta; Collins, Eileen G.; Ruggiero, Laurie; Park, Chang Gyu; Fritschi, Cynthia

doi:10.1111/jocn.14010

Cited by 30 publications

(28 citation statements)

References 45 publications

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“…Sleep disorder in people with diabetes has important clinical implications including impaired daytime functioning, poor glucose regulation, and poor quality of life (21). Hence, the assessment of the sleep disorder is essential for the effective management of diabetes (22).…”

Section: Discussionmentioning

confidence: 99%

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Ishibashi

Tavakoli

2020

Front. Endocrinol.

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Aims: To investigate the impact of thinning at individual grids of macular neuroretinal layers, clinical factors, and inadequate light exposure on the specific components of sleep disorder in patients with type 2 diabetes.Methods: One hundred twenty-four patients with type 2 diabetes without clinical evidences of diabetic retinopathy and neuropathy (HbA1c: 8.3%, diabetes duration; 8.7 years) and 54 age-and sex-matched control subjects (HbA1c: 5.6%) underwent detailed clinical, neurological, and ophthalmological examinations. The sleep disorder was assessed by the Pittsburgh Sleep Quality Index Japanese Version (PSQI-J). The temporal structures of daily life were assessed by the Munich Chronotype Questionnaire Japanese Version. The thickness at nine grids defined by the Early Treatment Diabetic Retinopathy Study of nine macular neuroretinal layers was determined by swept-source optical coherence tomography and OCT-Explorer. The associations between the individual components of sleep disorders and the thickness at each grid of macular neuroretinal layers, clinical factors, or the temporal structures of daily life were examined.Results: The prevalence of the sleep disorder, global score, and four individual PSQI-J scores in patients with type 2 diabetes were higher than control subjects. The thickness of two and five grids of two inner retinal layers and four to seven grids of four outer retinal layers in patients with type 2 diabetes was thinner than those in control subjects. The thickness at one to eight grids of four outer retinal layers in type 2 diabetic patients was inversely associated with global score and five individual scores of sleep disorder. The thinning at one to two grids of the inner plexiform layer was related to three high individual scores of sleep disorder. The inappropriate light exposure was associated with the sleep disorder and altered macular neuroretinal layers. The high HbA1c and LDL-cholesterol levels were related to the high global score and two individual scores of sleep disorder, respectively. Ishibashi and Tavakoli Neuroretinal Alterations and Sleep DisorderConclusion: In patients with type 2 diabetes, the thinning at grids of the inner plexiform layer and outer retinal layers was associated with the high scores of specific components of the sleep disorder. The sleep disorder was also related to hyperglycemia, dyslipidemia, and inappropriate light exposure. Keywords: inappropriate light exposure, optical coherence tomography, Pittsburgh sleep quality index Japanese version, sleep disorder, thinning of macular neuroretinal layer, type 2 diabetes Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; GCL, ganglion cell layer; INL, inner nuclear layer; IPL, inner plexiform layer; IS/OS, junction of inner and outer segment of photoreceptor; OCT, optical coherence tomography; ONL, outer nuclear layer; OPL, outer plexiform layer; OPR, outer segment of photoreceptor/retinal pigment epithelium complex; PSQI-J, Pittsburgh Sleep Quality Index Japanese Version; RNFL, retinal nerve f...

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Section: Discussionmentioning

confidence: 99%

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Ishibashi

Tavakoli

2020

Front. Endocrinol.

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“…As to nocturnal hyperglycaemia, higher glucose levels have been related to lower subjective sleep quality and duration . Higher night‐time glucose level often results in the need to urinate more frequently, which may disrupt sleep . Furthermore, higher glucose levels were associated with lower overnight excretion of melatonin in adults with type 1 diabetes , a hormone implicated in the proper regulation of sleep–wake patterns.…”

Section: Overview Of Findings In the Past 25 Yearsmentioning

confidence: 99%

Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science

Nefs

Bazelmans²,

Donga

et al. 2019

Diabet. Med.

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The aim of this review was to provide an overview of developments, clinical implications and gaps in knowledge regarding the relationship between diabetes and sleep over the past 25 years, with special focus on contributions from the behavioural sciences. Multiple prospective observational and experimental studies have shown a link between suboptimal sleep and impaired glucose tolerance, decreased insulin sensitivity and the development of type 2 diabetes. While prevalence rates of suboptimal sleep vary widely according to definition, assessment and sample, suboptimal subjective sleep quality appears to be a common reality for one‐third of people with type 1 diabetes and over half of people with type 2 diabetes. Both physiological and psychosocial factors may impair sleep in these groups. In turn, suboptimal sleep can negatively affect glycaemic outcomes directly or indirectly via suboptimal daytime functioning (energy, mood, cognition) and self‐care behaviours. Technological devices supporting diabetes self‐care may have both negative and positive effects. Diabetes and its treatment also affect the sleep of significant others. Research on the merits of interventions aimed at improving sleep for people with diabetes is in its infancy. Diabetes and sleep appear to be reciprocally related. Discussion of sleep deserves a central place in regular diabetes care. Multi‐day, multi‐method studies may shed more light on the complex relationship between sleep and diabetes at an individual level. Intervention studies are warranted to examine the potential of sleep interventions in improving outcomes for people with diabetes.

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“…To the Editor: I am very impressed by the article by Zhu et al (2018) entitled "Sleep disturbance in people with diabetes: A concept analysis" that was published in the Journal of Clinical Nursing. Zhu et al (2018) made progress in clarifying the conceptual definition of sleep disturbance in people with diabetes. Of particular interest to me were (a) the range of the concept that can be applied and (b) the antecedents of the concept.…”

Section: Letter Regarding "Sleep Disturbance In People With Diabetes:mentioning

confidence: 99%

“…I found that antecedents need to be added to encompass sleep patterns or sleep hygiene and physical activities. Zhu et al (2018) suggested physiological and psychological change as antecedents of the concept. Of course, these are vital antecedents that can occur prior to sleep disturbance in people with diabetes.…”

Section: Letter Regarding "Sleep Disturbance In People With Diabetes:mentioning

confidence: 99%

Letter regarding “sleep disturbance in people with diabetes: A concept analysis”

2018

Journal of Clinical Nursing

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Sleep disturbance in people with diabetes: A concept analysis

Abstract: Aims and objectives: To clarify the meaning of sleep disturbance in people with diabetes and examine its antecedents, attributes and consequences through concept analysis.Background: Sleep is crucial for health, and people with diabetes are frequently beset

Cited by 30 publications

References 45 publications

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science

Letter regarding “sleep disturbance in people with diabetes: A concept analysis”

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