Research Study Abstract

Relationship between sleep disturbance and self-care in adults with type 2 diabetes

  • Published on June 21, 2018

Aims: Type 2 diabetes (T2D) is a metabolic disorder requiring intensive self-care to maintain optimal glycemic control. Sleep disturbance is common in T2D patients and likely impairs glycemic control. Our aim was to examine the relationship between sleep disturbance and self-care in adults with T2D.

Methods: This study used a correlational design. Sixty-four adults with T2D were recruited. Validated instruments were used to measure self-care, subjective sleep disturbance, and covariates (e.g., diabetes distress, self-efficacy, fatigue, and daytime sleepiness). Over an 8-day period, the ActiGraph-wGT3X was used to measure objective sleep outcomes (e.g., total sleep time and number of awakenings). Bivariate correlation and multiple linear regression analyses were conducted.

Results: The mean age of the participants was 60.6 (SD 6.8) years (range 50–78), and 51.6% were women. Controlling for covariates, subjective sleep disturbance (β = − 0.26), diabetes distress (β = − 0.39), and daytime sleepiness (β = − 0.21) were strong predictors of diabetes self-care (R2 = 0.51, p < 0.001). When objective sleep parameters were used, the number of awakenings (β = − 0.23) also predicted self-care along with diabetes distress, fatigue, and daytime sleepiness (R2 = 0.57, p < 0.001).

Conclusions: Subjective sleep disturbance and frequent nocturnal awakenings are associated with worse diabetes self-care in adults with T2D. Healthcare providers are recommended to include comprehensive sleep assessment at every clinical visit. Diabetes educators may consider including sleep-related education in their diabetes self-management classes and/or counseling sessions.


  • Bingqian Zhu 1,4
  • Laurie Quinn 1
  • Mary C. Kapella 1
  • Ulf G. Bronas 1
  • Eileen G. Collins 1
  • Laurie Ruggiero 2,3
  • Chang G. Park 1
  • Cynthia Fritschi 1


  • 1

    Department of Biobehavioral Health Science, College of NursingUniversity of Illinois at ChicagoChicagoUSA

  • 2

    Institute for Health Research and Policy, School of Public HealthUniversity of Illinois at ChicagoChicagoUSA

  • 3

    School of NursingUniversity of DelawareNewarkUSA

  • 4

    School of NursingShanghai Jiaotong UniversityShanghaiChina


Acta Diabetologica