Saparwan N, Tohit N M, Salmiah M S
Klinik Kesihatan Seremban 2, Ministry of Health Malaysia, Negeri Sembilan, Malaysia.
Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Family Medicine, Bandar Tun Razak, Kuala Lumpur, Malaysia.
Med J Malaysia. 2023 Sep;78(5):627-634.
Poor sleep quality is common among patients with type 2 diabetes mellitus (T2DM). It has detrimental effects on physical and psychological health, as well as on quality of life. This study aimed to determine the prevalence of poor sleep quality among T2DM patients and to investigate the factors associated with this disorder.
A cross-sectional study was conducted at Klinik Kesihatan Seremban in Seremban district, Negeri Sembilan. Data were collected using the Malay version of the Pittsburgh Sleep Quality Index (PSQI-M) with a cut-off point of >5 as poor sleep quality. The Depression Anxiety Stress Scale-21 (DASS-21) was used to measure level of psychological distress. Data were collected between July 2022 until January 2023.
A total of 319 patients with T2DM participated. Their mean age was 63 (11) years, 58% were women and 42.9% were of Indian ethnicity. The mean total score of PSQI was 4.04 (2.21) and 23% of the participants had poor sleep quality. Multivariate logistic regression analysis revealed that poor sleep quality was significantly associated with Indian ethnicity (Adj. OR = 2.25; 95%CI: 1.05, 4.82; p = 0.037), separated or widowed (Adj. OR = 2.16; 95%CI = 1.15, 4.05; p = 0.016), having nocturia (Adj. OR = 2.13; 95%CI = 1.18, 3.84; p = 0.012) and depressive symptoms (Adj. OR = 3.41; 95%CI: 1.01, 11.48; p = 0.048).
Poor sleep quality was prevalent in almost a quarter of T2DM patients studied. Indian ethnicity, separated or widowed, having nocturia, and depressive symptoms were independently associated with poor sleep quality. Despite lower prevalence of poor sleep quality compared to other studies, identification of those at higher risk warrants further exploration in lifestyle management of patients with T2DM.
睡眠质量差在2型糖尿病（T2DM）患者中很常见。它对身心健康以及生活质量都有不利影响。本研究旨在确定T2DM患者中睡眠质量差的患病率，并调查与这种疾病相关的因素。
在森美兰州芙蓉区的芙蓉健康诊所进行了一项横断面研究。使用马来语版的匹兹堡睡眠质量指数（PSQI-M）收集数据，以>5分为睡眠质量差的临界值。使用抑郁焦虑压力量表-21（DASS-21）来测量心理困扰程度。数据收集时间为2022年7月至2023年1月。
共有319名T2DM患者参与。他们的平均年龄为63（11）岁，58%为女性，42.9%为印度族裔。PSQI的平均总分是4.04（2.21），23%的参与者睡眠质量差。多因素逻辑回归分析显示，睡眠质量差与印度族裔（调整后比值比=2.25；95%置信区间：1.05，4.82；p=0.037）、分居或丧偶（调整后比值比=2.16；95%置信区间=1.15，4.05；p=0.016）、夜尿症（调整后比值比=2.13；95%置信区间=1.18，3.84；p=0.012）和抑郁症状（调整后比值比=3.41；95%置信区间：1.01，11.48；p=0.048）显著相关。
在所研究的T2DM患者中，近四分之一的患者存在睡眠质量差的情况。印度族裔、分居或丧偶、夜尿症和抑郁症状与睡眠质量差独立相关。尽管与其他研究相比，睡眠质量差的患病率较低，但识别出高危人群值得在T2DM患者的生活方式管理中进一步探索。
