Quality of sleep and associated factors among type 2 diabetes patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Abstract

Abstract Background: Impaired sleep is associated with poor glycemic control and future risk of diabetes related complications. Most Diabetes Mellitus (DM) patients have poor sleep quality compared to the general population and despite the high prevalence of sleep disturbances and Type 2 Diabetes Mellitus (T2DM) in the African continent, there are few number of studies done to assess their implications. In our country’s context, quality of sleep in T2DM patients is an under recognized and under reported problem. Objectives: The purpose of this study was to assess the prevalence of quality of sleep and its associated factors among Type 2 diabetes patients at Zewditu Memorial Hospital. Methods: A cross-sectional study was conducted from March 2024 to May 2024 in Zewditu Memorial Hospital, Addis Ababa, Ethiopia. The study was conducted on 440 subjects who were randomly selected from T2DM patients coming for follow-up. A structured questionnaire, laboratory data and electronic medical records were used for data collection. All analysis were conducted using SPSS for windows version 26. Descriptive statistics, bivariate and multivariable logistic analyses were conducted to identify the prevalence and associated factors. The 95% significance level and a P- value of <0.05 was used to determine statistical significance. Results: The overall prevalence of poor sleep quality among the participants was 48.4% (95% CI: 43.7, 53.2) and the prevalence of good sleep quality was 51.6% (95% CI: 46.8, 56.3). Among the 440 study participants 220/440 (50.0%) had rated their subjective sleep quality as bad. Almost two third, 291/440(66.1%) of the participants had < 7hrs of sleep per night and more than one third, 170/440 (38.6%) have reported >30 minutes of sleep latency (the time it takes to fall asleep). Factors that were negatively associated with sleep quality in this study were married marital status (AOR=0.25) (95% CI: 0.06, 0.99), moderate intensity physical activity (AOR= 0.74) (95% CI: 0.59, 0.92) and low intensity physical activity (AOR=0.87) (95% CI: 0.78, 0.97) whereas factors that were positively associated with sleep quality were current tobacco smoking (AOR=24.42) (95%CI: 4.38, 36.05), presence of comorbidity (AOR=3.53) (95% CI: 2.15, 5.80) and poor glycemic control (AOR=2.28) (95% CI: 1.39, 3.73). Conclusion and recommendation: Poor sleep quality is highly prevalent among T2DM patients. Therefore, it is recommended to screen for sleep quality and to integrate sleep heath as part of T2DM patient care and treatment plan considering the ever-expanding population of T2DM patients. Married marital status, current tobacco smoking, low and moderate intensity physical activity, presence of comorbidity and poor glycemic control were significantly associated factors for sleep quality in this study. Therefore, it is recommended to have tailored regular exercise, to avoid smoking cigarettes and to have regular screening for the presence of comorbidities with optimal glycemic control for better sleep quality among T2DM patients. Key words: Type 2 diabetes Mellitus, Sleep Quality, Zewditu Memorial Hospital