Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 9;10(4):e26137.
doi: 10.1016/j.heliyon.2024.e26137. eCollection 2024 Feb 29.

Effect of fear of hypoglycaemia on sleep quality of patients with type 2 mellitus diabetes: The mediating role of alexithymia

Liuhong Tian  1 , Ke Liu  2 , Li Li  3 , Wenwen Wu  4   5   6 , Ningrui Zhang  6
Affiliations

Effect of fear of hypoglycaemia on sleep quality of patients with type 2 mellitus diabetes: The mediating role of alexithymia

Liuhong Tian et al. Heliyon. .

Abstract

Background: Patients with type 2 diabetes mellitus (T2DM) commonly experience poor sleep quality. This study aimed to investigate whether alexithymia mediates the association between fear of hypoglycaemia (FoH) and sleep quality in patients with T2DM.

Methods: From September 2021 to November 2021, a cross-sectional survey was conducted on 407 patients with T2DM in China. Data collection was made possible through the administration of the Chinese Version of the Worry Scale, Toronto Alexithymia Scale and Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Multiple linear regression analyses were also performed.

Results: A total of 65.6% of the participants were male, and 75.7% were aged 18-40 years. FoH showed a moderate and positive correlation with CPSQI scores (r = 0.308, p < 0.001). Alexithymia was weakly and positively correlated with CPSQI scores (r = 0.185, p < 0.001). Meanwhile, FoH exhibited a moderate and positive correlation with alexithymia (r = 0.422, p < 0.001), and difficulty in identifying (r = 0.414, p < 0.001) and describing feelings (r = 0.416, p < 0.001) and a weak and positive correlation with externally oriented thinking (r = 0.221, p < 0.001). The total effect (β = 0.408, p < 0.001) of FoH on CPSQI comprised not only the direct (β = 0.293, 95% confidence interval: 0.174-0.411, p < 0.001) but also the indirect effect (β = 0.115, p < 0.001) of alexithymia.

Conclusions: Alexithymia can mediate the association between FoH and sleep quality. Clinicians should recognize the potential effect of alexithymia and incorporate it in intervention planning and care. Addressing the affective disturbances arising from FoH can enhance emotional expression and sleep quality among T2DM patients.

Keywords: Alexithymia; Diabetes; Fear of hypoglycaemia; Sleep quality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Mediation effect hypothesis mode. * FoH = fear of hypoglycaemia.
Fig. 2
Fig. 2
Model of the mediating effect of alexithymia on FoH and sleep quality in patients with T2DM. * The normalised path coefficients are shown in the figure. X1–5 represent the five dimensions of FoH, M1–3 denote the three dimensions of alexithymia and Y1–7 refer to the seven dimensions of CPSQI; **p < 0.05, ***p < 0.001.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Collaborators G.B.D.D. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203–234. - PMC - PubMed
    1. International Diabetes Federation . tenth ed. Brussels; elgium: 2021. DF Diabetes Atlas.https://www.diabetesatlas.org Available at:
    1. Schipper S.B.J., et al. Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature. Diabetologia. 2021;64(11):2367–2377. - PMC - PubMed
    1. Barakat S., et al. Sleep quality in patients with type 2 diabetes mellitus. J. Clin. Med. Res. 2019;11(4):261–266. - PMC - PubMed
    1. Partinen M., et al. Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire. BMJ Open. 2021;11(12) - PMC - PubMed

LinkOut - more resources