Interaction of sleep quality and anxiety on quality of life in individuals with type 2 diabetes mellitus

PURPOSE: Sleep disturbances and anxious symptoms are very common in people with type 2 diabetes mellitus(T2DM). This study aimed to assess the interactive effects of poor sleep quality and anxious symptoms on the quality of life of people with T2DM. METHODS: Nine hundred and forty-four participants with T2DM were enrolled in a cross-sectional study. Demographic and physiological characteristics were recorded. Each participant completed a Chinese version of the Pittsburgh Sleep Quality Index, the Patient Health Questionnaire-9 and General Anxiety Disorder questionnaire, and the Diabetes Specificity Quality of Life scale. The products of poor sleep quality and anxiety were added to a logistic regression model to evaluate the multiplicative interactions, expressed as the relative excess risk of interaction, the attributable proportion of interaction, and the synergy index. RESULTS: Poor sleep quality and anxiety symptoms were associated with reduced quality of life. There was a significant interaction between poor sleep quality and anxiety symptoms; this combined effect significantly reduced quality of life scores by 6.09-fold. The relative excess risk of interactions was 1.36. CONCLUSIONS: The combined effect of poor sleep quality and anxiety symptoms reduces quality of life in people with T2DM. TRIAL REGISTRATION: ChiCTR-IOP-16008045. Registered 3 March 2016. A clinical study to investigate gum infection in patients undergoing kidney dialysis.