Prevalence And Determinants Of Poor Sleep Quality Among Patients With Type 2 Diabetes Mellitus

Abstract

Background

Cardiomyopathies are a heterogeneous group of myocardial disorders associated with significant morbidity, heart failure, ventricular arrhythmias, and sudden cardiac death. Accurate differentiation between ischemic and non-ischemic cardiomyopathy is essential because the underlying etiology influences therapeutic strategies, risk stratification, and prognosis. Although two-dimensional echocardiography remains the first-line imaging modality for the assessment of ventricular structure and function, cardiac magnetic resonance (CMR) provides superior tissue characterization, myocardial strain analysis, and detection of myocardial fibrosis through late gadolinium enhancement. The present study was undertaken to evaluate the clinical profile and compare echocardiographic and CMR findings among patients with cardiomyopathy in a tertiary care hospital, with emphasis on their complementary diagnostic value.

Aim: This study aimed to assess the prevalence of poor sleep quality and its associated factors among patients with T2DM.

Materials and Methods: This prospective cross-sectional study was conducted at a tertiary care center, India, over two months. Adult patients (≥18 years) with T2DM were enrolled. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a global score ≥5 defining poor sleep quality. Demographic and clinical variables, including age, sex, body mass index (BMI), duration of diabetes, treatment modality, random blood sugar (RBS), and presence of neuropathy, were collected. Logistic regression analysis was performed to identify factors associated with poor sleep quality.

Results: A total of 109 patients were included (mean age 59.85 ± 11.10 years; 40.4% female). Poor sleep quality was observed in 68.8% of participants (75/109; 95% CI: 59.6–76.7), with a mean PSQI score of 6.95 ± 3.79. Higher prevalence was noted among females (75.0% vs 64.6%) and those with neuropathy (76.9% vs 66.3%). However, no variables were significantly associated with poor sleep quality on multivariable analysis, including age (adjusted OR 1.13 per 10 years; p=0.566), female sex (adjusted OR 1.80; p=0.207), BMI (adjusted OR 0.95; p=0.300), RBS (adjusted OR 1.25 per 50 mg/dL; p=0.209), duration of diabetes (adjusted OR 0.89; p=0.512), and neuropathy (adjusted OR 1.56; p=0.425).

Conclusion: Poor sleep quality is highly prevalent among patients with T2DM, affecting nearly two-thirds of individuals. The absence of independent predictors suggests a multifactorial etiology, highlighting the need for routine sleep assessment as part of comprehensive diabetes care.