Sleep Problems Worsen Diabetes Distress in Type 2 Diabetes, finds study
According to a new research study, sleep impairment, particularly poor sleep quality, short sleep duration, and daytime dysfunction is significantly associated with increased diabetes distress in adults with type 2 diabetes, negatively impacting both disease management and mental well-being. The study was published in Diabetic Medicine journal by Hilde K. R. Riise and colleagues.
Diabetes distress is the emotional burden and frustration that individuals with diabetes can experience when attempting to control their disease. It differs from clinical depression but is linked to worse outcomes, such as diminished self-care and poor glycemic regulation. Sleep disturbances, also prevalent in individuals with T2D, have been suspected to contribute to heightened psychological stress. To investigate this, researchers employed answers to the HUNT4 sleep questionnaire, which gathered information on sleep problems such as snoring, sleep apnea, difficulty in falling asleep, nocturnal awakenings, early morning waking, excessive daytime sleepiness due to poor sleep, and restless legs. Diabetes distress was measured with the established PAID-5 questionnaire.
This cross-sectional study examined data on 1,954 adults with T2D who answered the HUNT4 survey. Sleep-related items were taken from the tested sleeping HUNT-Questionnaire, and the participants also indicated the average daily number of hours spent sleeping. Distress due to diabetes was assessed by the PAID-5 scale. Multivariate linear regression models were used to estimate the relationship of different sleep issues and distress scores, controlling for demographic, clinical, and mental health covariates. Prevalence rates and 95% confidence intervals were computed for each sleep impairment group.
Results
• The findings revealed a distinct and uniform pattern: individuals who reported sleep impairments had greater diabetes distress scores.
• Participants who slept ≤7 hours/night had an increased distress score: B = 0.6 (95% CI 0.2, 0.9).
• Snoring correlated with increased distress: B = 0.6 (95% CI 0.1, 1.1).
• They had a significantly larger increase in distress scores: B = 1.4 (95% CI 0.8, 2.2).
• Waking up at night was also significantly associated: B = 1.1 (95% CI 0.6, 1.6).
• Early morning waking had the same relationship: B = 1.2 (95% CI 0.7, 1.8).
• The largest increase in distress was reported by those who had difficulty functioning during the day because they weren't sleeping well: B = 2.6 (95% CI 1.7, 3.6).
• Restless legs were also associated with distress: B = 0.8 (95% CI 0.2, 1.3).
• These findings indicate that even ubiquitous and frequently-neglected sleep issues can have a very significant impact on the emotional load of T2D sufferers.
This research concluded that various forms of sleep impairment were all strongly related to greater diabetes distress levels in patients with type 2 diabetes. These findings emphasize the urgent importance of integrating sleep evaluation and treatment into overall diabetes care, given the potential for improving sleep health to be a major strategy for lowering diabetes-associated emotional distress.
Reference:
Riise HKR, Haugstvedt A, Igland J, et al. Diabetes distress and sleep impairment in type 2 diabetes: A population-based cross-sectional study-The HUNT Study, Norway. Diabet Med. Published online July 25, 2025. doi:10.1111/dme.70106
