Association of Sleep Quality and Duration with Poor Glycemic Control among Type 2 Diabetes Mellitus Patients in Felege Hiwot Comprehensive Referral and Specialized Hospital, Northwest Ethiopia

Abstract

Abstract
Background: Poor glycemic control is currently the most serious tragedy in type 2 diabetic patients. Sleep disruption
is associated with increased circulating cortisol levels, sympathetic activity, and epinephrine secretion. These physiological conditions are either directly or indirectly related to glucose metabolism in our body cells. However, sleep
quality and duration of glycemic control levels have yet to be studied in Ethiopia. Therefore, this study aimed to assess
the association of Sleep quality and duration with Glycemic control among type 2 diabetes mellitus patients in Felege
Hiwot Comprehensive Referral and Specialized Hospital, Northwest Ethiopia.
Methods: An institutional-based cross-sectional study was conducted among 407 types 2 diabetes mellitus patients
selected by systematic random sampling technique from July 1, 2020, to April 28, 2021. Five milliliters of blood were
taken from each patient to determine their fasting blood sugar level. The Pitts Burg Sleep Quality Index was used to
evaluate patients' sleep quality, and the STOP-BANG questionnaire was used to determine the presence or absence of
Obstructive Sleep Apnea. Data were analyzed using STATA version 14.1. Variables with a P-value of <0.05 were
considered statistically significant.
Results: The magnitude of poor glycemic control was 54.05% (95% CI: 49.20%, 58.90%). Being female (AOR =
2.7, 95% CI: 1.23, 6.15), type 2 diabetes mellitus patients who had poor sleep quality (AOR = 3.3, 95% CI: 1.16,
9.37), patients who were at low risk of Obstructive Sleep Apnea (AOR = 0.03, 95% CI: 0.01, 0.12), intermediate risk
of Obstructive Sleep Apnea (AOR = 0.14, 95% CI: 0.05, 0.43), short sleep duration (< 6 hours) (AOR = 8.3, 95% CI:
2.66, 25.85) were associated with glycemic control.
Conclusion: The prevalence of poor glycemic control in type 2 diabetes mellitus patients was high. Poor sleep quality,
both short and long sleep duration, and intermediate and low risk of obstructive sleep apnea were statistically associated with poor glycemic control. Thus hospitals that have diabetes mellitus follow-up clinics should assess and consult
sleep quality, duration, and obstructive sleep apnea type 2 diabetes mellitus patients to maintain a glycemic level.
Keywords: glycemic control; sleep quality; sleep duration; napping; types 2 diabetes mellitus