From the Department of Kinesiology & Health Education (Woo, Tabibi, Cebulske, Tanaka, Steinhardt), The University of Texas at Austin, Austin, Texas; and Department of Psychiatry (Lehrer), University of Pittsburgh, Pittsburgh, Pennsylvania.
Psychosom Med. 2024 May 1;86(4):307-314. doi: 10.1097/PSY.0000000000001298.
Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes.
Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms.
Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c.
Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population.
ClinicalTrials.gov identifier NCT04282395.
睡眠对与糖尿病相关的健康结果很重要。本研究使用多维睡眠健康框架，考察了个体睡眠健康维度以及综合睡眠健康评分与血红蛋白 A1c（HbA1c）和抑郁症状在 2 型糖尿病非裔美国成年人中的关联。
参与者（N=257；平均年龄 62.5 岁）通过当地教堂招募。使用腕戴活动记录仪和睡眠问卷数据，采用 RuSATED 框架（规律性、满意度、警觉性、时间安排、效率、时长）评估多维睡眠健康。将个体睡眠维度分为睡眠健康不良或良好，并将其加总为综合评分。使用 DCA Vantage™分析仪或 A1CNow®自我检查评估 HbA1c。使用患者健康问卷（PHQ-9）评估抑郁症状。回归模型检验了个体睡眠维度和综合睡眠健康与 HbA1c 和抑郁症状的关联。
更高的综合睡眠健康评分与出现轻微以上抑郁症状（PHQ-9≥5）的可能性较低相关（比值比[OR] = 0.578，95%置信区间[CI] = 0.461-0.725）。几个个体睡眠维度，包括不规律（OR = 1.013，CI = 1.005-1.021）、满意度低（OR = 3.130，CI = 2.095-4.678）和警觉性降低（OR = 1.866，CI = 1.230-2.833）与出现抑郁症状的可能性较高相关。综合睡眠健康评分和个体睡眠维度均与 HbA1c 无关。
在 2 型糖尿病非裔美国成年人中，更好的多维睡眠健康与较低的抑郁症状相关。需要进行纵向研究，以确定该人群中多维睡眠健康与抑郁症状之间的因果关联。
ClinicalTrials.gov 标识符 NCT04282395。
