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2型糖尿病患者睡眠障碍的预测因素

Predictors of sleep disorders among patients with type 2 diabetes mellitus.

作者信息

Gupta Shaloo, Wang Zhixiao

机构信息

Health Outcomes Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ, 08540, USA.

Health Economics & Outcomes Research, Eisai, Inc., 100 Tice Blvd., Woodcliff Lake, NJ, 07677, USA.

出版信息

Diabetes Metab Syndr. 2016 Oct-Dec;10(4):213-220. doi: 10.1016/j.dsx.2016.06.009. Epub 2016 Jun 8.

Abstract

AIMS

This study examined the prevalence of sleep disorders (SD) and self-reported sleep symptoms and risk factors among adult patients diagnosed with T2DM.

METHODS

Data were obtained from the 2012 US National Health and Wellness Survey, an annual Internet-based survey. A total of 7239 participants reported a diagnosis of T2DM. Patients also provided information on diagnosis of SD (e.g., insomnia, sleep breathing disorder, other sleep conditions, etc.) and regularly experienced sleep symptoms (e.g., difficulty falling asleep, sleep apnea, daytime sleepiness, difficulty staying awake, etc.). Logistic regressions were used to examine factors associated with SD and symptoms.

RESULTS

The average age was 59.9 (standard deviation=12.2), 59.5% were male, 24.4% were diagnosed with SD, 76.8% reported experiencing any sleep symptom regularly (difficulty falling asleep, 30.5%; sleep apnea, 17.4%; daytime sleepiness, 26.8%; difficulty staying awake, 10.1%). Logistic regression models showed the strongest predictors of diagnosed SD were obesity class (OC) III (OR=2.20), White (OR=1.92), OC II (OR=1.57), smoking (OR=1.57), lower income (OR=1.49-1.19), unemployment (OR=1.38), and comorbidities (OR=1.35), all p<0.05. The strongest predictors of any sleep symptom were OC III (OR=2.22), OC II (OR=1.78), lower income (OR=1.74-1.24), female gender (OR=1.72), OC I (OR=1.60), White (OR=1.54), and smoking (OR=1.47), all p<0.05.

CONCLUSIONS

Almost 25% of patients with T2DM were diagnosed with SD and over 75% reported experiencing at least one sleep symptom regularly. SD and symptoms were strongly associated with obesity, White ethnicity, gender, low income, and smoking. Interventions focusing on weight management and smoking cessation have shown to improve T2DM and may improve SD.

摘要

目的

本研究调查了成年2型糖尿病患者睡眠障碍(SD)的患病率、自我报告的睡眠症状及风险因素。

方法

数据来自2012年美国国民健康与 Wellness 调查,这是一项基于互联网的年度调查。共有7239名参与者报告患有2型糖尿病。患者还提供了关于睡眠障碍诊断(如失眠、睡眠呼吸障碍、其他睡眠状况等)以及经常出现的睡眠症状(如入睡困难、睡眠呼吸暂停、日间嗜睡、难以保持清醒等)的信息。采用逻辑回归分析来研究与睡眠障碍及症状相关的因素。

结果

平均年龄为59.9岁(标准差 = 12.2),59.5%为男性,24.4%被诊断为睡眠障碍,76.8%报告经常出现任何睡眠症状(入睡困难,30.5%;睡眠呼吸暂停,17.4%;日间嗜睡,26.8%;难以保持清醒,10.1%)。逻辑回归模型显示,诊断为睡眠障碍的最强预测因素为III级肥胖(OC)(比值比[OR]=2.20)、白人(OR = 1.92)、II级OC(OR = 1.57)、吸烟(OR = 1.57)、低收入(OR = 1.49 - 1.19)、失业(OR = 1.38)和合并症(OR = 1.35),所有p<0.05。任何睡眠症状的最强预测因素为III级OC(OR = 2.22)、II级OC(OR = 1.78)、低收入(OR = 1.74 - 1.24)、女性(OR = 1.72)、I级OC(OR = 1.60)、白人(OR = 1.54)和吸烟(OR = 1.47),所有p<0.05。

结论

近25%的2型糖尿病患者被诊断为睡眠障碍,超过75%报告经常出现至少一种睡眠症状。睡眠障碍及症状与肥胖、白人种族、性别、低收入和吸烟密切相关。专注于体重管理和戒烟的干预措施已显示可改善2型糖尿病,可能也会改善睡眠障碍。

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