2 型糖尿病患者共病阻塞性睡眠呼吸暂停和失眠及其与情绪和糖尿病相关困扰的关系。
Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus.
机构信息
University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.
VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
出版信息
J Clin Sleep Med. 2022 Apr 1;18(4):1103-1111. doi: 10.5664/jcsm.9812.
STUDY OBJECTIVES
Previous research suggests that obstructive sleep apnea (OSA) and insomnia frequently coexist and are prevalent in persons with type 2 diabetes mellitus. This study compared mood and diabetes-related distress among OSA, insomnia, and comorbid OSA and insomnia groups in persons with type 2 diabetes mellitus.
METHODS
A secondary analysis was conducted with baseline data from 2 independent randomized controlled trials evaluating the efficacy of OSA and insomnia treatment. The pooled sample (n = 224) included participants with OSA only (n = 68 [30.4%]), insomnia only (n = 107 [47.8%]), and OSA and insomnia (OSA+insomnia; n = 49 [21.9%]). OSA was defined as an apnea-hypopnea index ≥ 15 events/h; insomnia was defined as an Insomnia Severity Index score ≥ 15. Mood was measured by the Profile of Mood States total and subscale scores; diabetes-related distress was assessed by the Problem Areas in Diabetes questionnaire. One-way analysis of covariance and multivariate analysis of covariance were conducted, controlling for demographic characteristics and restless legs syndrome.
RESULTS
The insomnia group had on average significantly higher scores for total mood disturbance (insomnia vs OSA = 45.32 vs 32.15, = .049), tension-anxiety (insomnia vs OSA = 12.64 vs 9.47, = .008), and confusion-bewilderment (insomnia vs OSA = 9.45 vs 7.46, = .036) than the OSA group. The OSA+insomnia group had on average significantly greater diabetes-related distress than the OSA group (OSA+insomnia vs OSA = 40.61 vs 30.97, = .036).
CONCLUSIONS
Insomnia may have greater impact on mood disturbance and diabetes-related distress than OSA in persons with type 2 diabetes mellitus. In particular, comorbid insomnia may contribute to greater diabetes-related distress in persons with type 2 diabetes mellitus and OSA.
CITATION
Jeon B, Luyster FS, Sereika SM, DiNardo MM, Callan JA, Chasens ER. Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus. . 2022;18(4):1103-1111.
研究目的
既往研究表明，阻塞性睡眠呼吸暂停（OSA）和失眠常并存，并在 2 型糖尿病患者中高发。本研究比较了 OSA、失眠及 OSA 合并失眠患者的情绪和与糖尿病相关的困扰。
方法
对两项评估 OSA 和失眠治疗疗效的独立随机对照试验的基线数据进行了二次分析。汇总样本（n=224）包括单纯 OSA 患者（n=68[30.4%]）、单纯失眠患者（n=107[47.8%]）和 OSA 合并失眠患者（OSA+失眠；n=49[21.9%]）。OSA 定义为呼吸暂停-低通气指数≥15 次/小时；失眠定义为失眠严重程度指数评分≥15。采用心境状态量表总分和分量表评分评估情绪；用糖尿病相关困扰问卷评估与糖尿病相关的困扰。采用单因素协方差分析和多变量协方差分析，控制人口统计学特征和不宁腿综合征。
结果
失眠组的总体情绪障碍（失眠 vs OSA=45.32 对 32.15， =.049）、紧张焦虑（失眠 vs OSA=12.64 对 9.47， =.008）和困惑迷茫（失眠 vs OSA=9.45 对 7.46， =.036）评分均值显著高于 OSA 组。OSA+失眠组与 OSA 组相比，与糖尿病相关的困扰显著更大（OSA+失眠 vs OSA=40.61 对 30.97， =.036）。
结论
在 2 型糖尿病患者中，失眠对情绪障碍和与糖尿病相关的困扰的影响可能大于 OSA。特别是，2 型糖尿病患者合并 OSA 和失眠可能会导致更大的与糖尿病相关的困扰。
引文
Jeon B, Luyster FS, Sereika SM, DiNardo MM, Callan JA, Chasens ER. Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus.. 2022;18(4):1103-1111.
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