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Observational Study
. 2016 Apr 5:17:40.
doi: 10.1186/s12875-016-0435-x.

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes

Pan Zhang  1 , Peian Lou  2 , Guiqiu Chang  3 , Peipei Chen  3 , Lei Zhang  3 , Ting Li  3 , Cheng Qiao  3
Affiliations
Observational Study

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes

Pan Zhang et al. BMC Fam Pract. .

Abstract

Background: Poor sleep quality and depression negatively impact the health-related quality of life of patients with type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes.

Methods: Patients with type 2 diabetes (n = 944) completed the Diabetes Specificity Quality of Life scale (DSQL) and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S).

Results: Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive symptoms was observed only in women.

Conclusions: Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.

Keywords: Attributable proportion; Depression; Diabetes specificity quality of life scale; Interaction; Relative excess risk of interaction; Sleep quality; Synergy index; Type 2 diabetes mellitus.

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