The relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes: An integrative review.
Bingqian Zhu, Patricia E Hershberger, Mary C Kapella and 1 others
PMID 28544107WHAT IT FOUND
In adults with type 2 diabetes, poor sleep quality was linked with higher blood glucose and HbA1c in 14 of 22 studies.
Sleep duration links were weaker and inconsistent. The review does not show that improving sleep improves diabetes control.
Key findings
01Sleep quality was associated with glycemic control in 14 of 22 studies.
02Sleep duration was not consistently linked to glycemic control; six of eight studies examining a straight-line relationship found no significant association.
03Most included studies were cross-sectional, so the review cannot show whether poor sleep led to poorer glycemic control or the reverse.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, so they cannot show whether sleep problems caused poorer diabetes control or poorer control affected sleep. The review combined very different study designs and samples, so it could not produce one overall estimate of effect. Sleep was measured in different ways, including patient report and objective monitors, and the quality of those sleep measures was often not reported. Studies varied in whether they adjusted for age, sex, diabetes duration, neuropathy and other factors that can influence sleep and glucose. All eligible studies were included regardless of quality score, and quality scores ranged from 25 to 39 out of 40. Only English-language published studies were searched, so relevant unpublished or non-English studies may have been missed.
Declared interests
The authors declared no conflicts of interest. The supplied text does not report a funding statement.
The easy way to misread this
Do not conclude that improving sleep will improve glycemic control. Most included studies were cross-sectional, so they cannot show cause and effect, and the sleep duration findings were inconsistent.