Association between Sleep Quality and Glycaemic Control, Quality of Life, Obesity and Other Metabolic Risk Factors among Patients with Diabetes Mellitus

Introduction: Diabetes mellitus is a growing public health challenge in Southeast Asia, with rising concerns about factors influencing its management beyond conventional treatments. While sleep quality has been linked to metabolic health in various populations, its impact on glycemic control and related parameters in Sri Lankan individuals living with diabetes remain unexplored.
Objective: To explore the association between sleep quality, glycemic control, and other metabolic parameters (obesity, hypertension, and diabetes-related quality of life) in patients with diabetes in Sri Lanka.
Methods: A descriptive cross-sectional study was conducted among 220 adult patients with diabetes attending diabetes clinics at the National Hospital of Sri Lanka. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), while glycemic control was measured with HbA1c levels. Metabolic parameters, including body mass index (BMI), blood pressure, and diabetes-related quality of life (DQoL), were also evaluated. Data were analyzed using descriptive statistics, correlation analysis, and linear regression.
Results: The mean age of participants was 60.37±10.3 years, with 97.7% diagnosed with type 2 diabetes. The mean HbA1c was 8.3±2.2%, and 36.8% of patients reported poor sleep quality (PSQI > 5). Sleep quality showed a significant positive correlation with DQoL (r = 0.197, p = 0.003) and higher PSQI was associated with poorer glycemic control in adjusted linear regression (B = 0.09, p = 0.05). Additionally, poorer sleep quality was linked to an increased likelihood of hypertension (Exp(B) = 1.12, p = 0.033), although no significant association was found with obesity.
Conclusion: The findings suggest that poor sleep quality is associated with worse glycemic control, hypertension, and lower quality of life in Sri Lankan diabetes patients. These results emphasize the need to consider sleep quality as an integral part of diabetes management. Further studies are needed to examine causal links and explore the potential benefits of sleep interventions in this population.