The relationship between Pittsburgh Sleep Quality Index subscales and diabetes control.


Journal Article

Objectives Data suggest that poor sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) contributes to suboptimal diabetes control. How the subscales comprising the PSQI individually relate to diabetes control is poorly understood. Methods In order to explore how PSQI subscales relate to diabetes control, we analyzed baseline data from a trial of a telemedicine intervention for diabetes. We used multivariable modeling to examine: (1) the relationship between the global PSQI and hemoglobin A1c (HbA1c); (2) the relationships between the 7 PSQI subscales and HbA1c; and (3) medication nonadherence as a possible mediating factor. Results Global PSQI was not associated with HbA1c ( n = 279). Only one PSQI subscale, sleep disturbances, was associated with HbA1c after covariate adjustment; HbA1c increased by 0.4 points for each additional sleep disturbances subscale point (95%CI 0.1 to 0.8). Although the sleep disturbances subscale was associated with medication nonadherence (OR 2.04, 95%CI 1.27 to 3.30), a mediation analysis indicated nonadherence does not mediate the sleep disturbances-HbA1c relationship. Discussion The sleep disturbances subscale may drive the previously observed relationship between PSQI and HbA1c. The mechanism for the relationship between sleep disturbances and HbA1c remains unclear, as does the impact on HbA1c of addressing sleep disturbances.

Full Text

Duke Authors

Cited Authors

  • Telford, O; Diamantidis, CJ; Bosworth, HB; Patel, UD; Davenport, CA; Oakes, MM; Crowley, MJ

Published Date

  • January 2018

Published In

Start / End Page

  • 1742395318759587 -

PubMed ID

  • 29466873

Pubmed Central ID

  • 29466873

Electronic International Standard Serial Number (EISSN)

  • 1745-9206

International Standard Serial Number (ISSN)

  • 1742-3953

Digital Object Identifier (DOI)

  • 10.1177/1742395318759587


  • eng