Purpose

The purpose of this study was to examine age-related differences in mood, diabetes-related distress, and functional outcomes in activities sensitive to impaired sleep in adults with type 2 diabetes mellitus (T2DM) and comorbid obstructive sleep apnea (OSA) and insomnia. This study also evaluated the associations of age, insomnia severity, and OSA severity on outcome variables.

Methods

This study was a secondary analysis of pooled baseline data from 2 randomized controlled trials among adults with T2DM with symptoms of sleep disorders (N = 145,109 younger adults, 36 older adults; 46.2% male; 67.6% white). Comorbid OSA and insomnia was defined as Apnea-Hypopnea Index ≥5 events per hour and Insomnia Severity Index ≥10. Outcome variables included mood, diabetes-related distress, and functional outcomes.

Results

Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all Ps < .05). Insomnia severity was associated with worse mood (b = 2.59, P < .001) and diabetes-related distress (b = 1.40, P < .001) and lower functional outcome (b = −0.22, P < .001). Older age was associated with lower diabetes-related distress (b = −0.44, P = .040).

Conclusion

Older age was a protective factor of mood disturbance, diabetes-related distress, and functional impairment in adults with T2DM and comorbid OSA and insomnia. Insomnia severity was associated with greater mood disturbance, diabetes-related distress, and functional impairment when OSA and insomnia coexist. The results suggest that diabetes care and education specialists should assess patients for impaired sleep.

中文翻译：

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成人2型糖尿病合并并发阻塞性睡眠呼吸暂停和失眠的情绪，糖尿病相关困扰和功能结局的年龄相关差异

目的

这项研究的目的是检查与2型糖尿病（T2DM），合并症，阻塞性睡眠呼吸暂停（OSA）和失眠的成年人对睡眠障碍敏感的活动有关的情绪，糖尿病相关困扰和功能结局的年龄相关差异。这项研究还评估了年龄，失眠严重程度和OSA严重程度与结局变量的关系。

方法

这项研究是对2项患有睡眠障碍症状的T2DM成人的随机对照试验（N = 145,109岁以下的年轻人，36岁以上的成年人； 46.2％的男性； 67.6％的白人）的汇总基线数据的二次分析。合并OSA和失眠的定义为每小时呼吸暂停低通气指数≥5事件，失眠严重度指数≥10。结果变量包括情绪，与糖尿病有关的困扰和功能结果。

结果

相对于年轻人，老年人报告了更好的情绪，较低的糖尿病相关困扰和更高的功能预后（所有P s <.05）。失眠的严重程度与情绪恶化（b = 2.59，P <.001）和糖尿病相关的困扰（b = 1.40，P <.001）和较低的功能预后（b = -0.22，P <.001）相关。老年与较低的糖尿病相关困扰有关（b = −0.44，P = .040）。

结论

老年是患有T2DM和合并症OSA和失眠的成年人的情绪障碍，糖尿病相关困扰和功能障碍的保护因素。当OSA和失眠共存时，失眠的严重程度与更大的情绪障碍，糖尿病相关的困扰和功能障碍有关。结果表明，糖尿病护理和教育专家应评估患者睡眠障碍。