The relationship between Pittsburgh Sleep Quality Index subscales and diabetes control.


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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Publication Info

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

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Clarissa Jonas Diamantidis

Adjunct Associate Professor of Medicine

Tina Davenport

Biostatistician, Senior

Clemontina A. Davenport earned a MSTAT and PhD in Statistics at NC State University. Dr. Davenport has extensive collaborative research experience investigating factors that may explain racial disparities in health outcomes, primarily in kidney disease, but also in diabetes, hypertension cardiovascular disease, and other areas. She teaches a first-year masters level class and is passionate about teaching, mentorship, and the importance of diversity and equity in research and healthcare.


Matthew Janik Crowley

Associate Professor of Medicine

Diabetes, Hypertension, Health Services Research

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