The relationship between Pittsburgh Sleep Quality Index subscales and diabetes control.
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2019-09
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OBJECTIVES:: Data suggest that poor sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) contributes to suboptimal diabetes control. How the subscales comprising the PSQI individually relate to diabetes control is poorly understood. METHODS:: In order to explore how PSQI subscales relate to diabetes control, we analyzed baseline data from a trial of a telemedicine intervention for diabetes. We used multivariable modeling to examine: (1) the relationship between the global PSQI and hemoglobin A1c (HbA1c); (2) the relationships between the 7 PSQI subscales and HbA1c; and (3) medication nonadherence as a possible mediating factor. RESULTS:: Global PSQI was not associated with HbA1c (n = 279). Only one PSQI subscale, sleep disturbances, was associated with HbA1c after covariate adjustment; HbA1c increased by 0.4 points for each additional sleep disturbances subscale point (95%CI 0.1 to 0.8). Although the sleep disturbances subscale was associated with medication nonadherence (OR 2.04, 95%CI 1.27 to 3.30), a mediation analysis indicated nonadherence does not mediate the sleep disturbances-HbA1c relationship. DISCUSSION:: The sleep disturbances subscale may drive the previously observed relationship between PSQI and HbA1c. The mechanism for the relationship between sleep disturbances and HbA1c remains unclear, as does the impact on HbA1c of addressing sleep disturbances.
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Telford, Onala, Clarissa J Diamantidis, Hayden B Bosworth, Uptal D Patel, Clemontina A Davenport, Megan M Oakes and Matthew J Crowley (2019). The relationship between Pittsburgh Sleep Quality Index subscales and diabetes control. Chronic illness, 15(3). pp. 210–219. 10.1177/1742395318759587 Retrieved from https://hdl.handle.net/10161/29855.
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Clarissa Jonas Diamantidis
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
Uptal Dinesh Patel
Uptal Patel, MD is an Adjunct Professor interested in population health with a broad range of clinical and research experience. As an adult and pediatric nephrologist with training in health services and epidemiology, his work seeks to improve population health for patients with kidney diseases through improvements in prevention, diagnosis and treatment. He has led clinical and translational research programs to improve detection and management of kidney disease in a variety of populations.
His current efforts seek to advance targeted therapies for immune-mediated diseases as the Senior Vice President and Head of Development at HI-Bio, at Biogen. Prior to being CMO at HI-Bio, he led clinical strategy, translation, and development of the kidney portfolios at AstraZeneca (within the early cardiovascular, renal, and metabolism therapeutic area) and Gilead Sciences (within the inflammation therapeutic area).
He currently also serves as Chair of the Board of Directors for the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology and the FDA to catalyze innovation and the development of safe and effective patient-centered therapies for people with kidney diseases. He completed training at the University of Michigan in internal medicine, pediatrics, adult nephrology, pediatric nephrology, and health services research after attending medical school at UCSF.
Matthew Janik Crowley
Diabetes, Hypertension, Health Services Research
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