Jeon, Bomin
(2022)
The roles of obstructive sleep apnea and insomnia on mood, diabetes-related distress, and glycemic control in adults with type 2 diabetes mellitus.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Obstructive sleep apnea (OSA) and insomnia are common sleep disorders and frequently coexist. Mood disturbances and diabetes-related distress are common psychological symptoms in type 2 diabetes mellitus (T2DM) and known barriers to glycemic control. Understanding how comorbid OSA and insomnia (OSA+I) contribute to mood and diabetes-related distress could be significant to improve glycemic outcomes in T2DM.
Purpose: The aims of this study were to 1) compare mood states and diabetes-related distress in OSA+I, OSA, and insomnia in adults with T2DM, 2) examine insomnia as a possible moderator of the association between OSA with mood states and diabetes-related distress in adults with
T2DM and OSA, and 3) examine mood disturbances and diabetes-related distress as potential mediators of the relationship between OSA and insomnia with glucose outcome in adults with
T2DM and OSA.
Methods: This study was a secondary analysis of the pooled baseline data from two independent randomized controlled trials. OSA severity was determined by an Apnea-Hypopnea Index from in-home ApneaLinkPlus® device data. Questionnaires measured insomnia severity, mood states,
and diabetes-related distress. Glucose outcome was measured by hemoglobin A1c (HbA1c). Aim 1 used one-way analysis of covariance and one-way multivariate analysis of covariance. Aim 2used hierarchical multiple linear regression and multivariate linear analysis. Aim 3 used mediation analysis with bootstrapped samples. Clinical and sociodemographic covariates were controlled in all analyses.
Results: Insomnia group had greater mood disturbances (p = .017) and OSA+I group had greater diabetes-related distress than OSA group (p = .033) in adults with T2DM. As insomnia severity increased, the deleterious effect of OSA on mood disturbances decreased (b = -.048, p = .017) and only insomnia was associated with diabetes-related distress in adults with T2DM and OSA (b =1.133, p < .001). Persons with greater insomnia severity had greater diabetes-related distress, which was associated with heightened HbA1c (indirect effect: b = .0169, se = .0083, 95% CI
[.0028, .0348]).
Conclusions: Insomnia, not OSA, was the primary underlying sleep disorder associated with mood disturbances and diabetes-related distress in T2DM. Insomnia could be a modifiable factor to reduce diabetes-related distress and improve glycemic outcomes in T2DM.
Share
| Citation/Export: |
|
| Social Networking: |
|
Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
|
| Date: |
28 April 2022 |
| Date Type: |
Publication |
| Defense Date: |
25 March 2022 |
| Approval Date: |
28 April 2022 |
| Submission Date: |
27 April 2022 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
194 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Nursing > Nursing |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Obstructive sleep apnea, Insomnia, Comorbid obstructive sleep apnea and insomnia, Mood, Diabetes-related distress, Glycemic control, Type 2 diabetes mellitus |
| Date Deposited: |
28 Apr 2022 15:03 |
| Last Modified: |
28 Apr 2022 15:03 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/42773 |
Metrics
Monthly Views for the past 3 years
Plum Analytics
Actions (login required)
 |
View Item |
![[feed]](/images/feed-icon-32x32.png){kind=icon}