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Jeon B, Sereika SM, Callan JA, Luyster FS, DiNardo MM, Chasens ER. Age-Related Differences in Mood, Diabetes-Related Distress, and Functional Outcomes in Adults With Type 2 Diabetes Mellitus and Comorbid Obstructive Sleep Apnea and Insomnia. The Diabetes educator. 2020 Dec 1; 46(6):540-551.
PURPOSE: The purpose of this study was to examine age-related differences in mood, diabetes-related distress, and functional outcomes in activities sensitive to impaired sleep in adults with type 2 diabetes mellitus (T2DM) and comorbid obstructive sleep apnea (OSA) and insomnia. This study also evaluated the associations of age, insomnia severity, and OSA severity on outcome variables. METHODS: This study was a secondary analysis of pooled baseline data from 2 randomized controlled trials among adults with T2DM with symptoms of sleep disorders (N = 145,109 younger adults, 36 older adults; 46.2% male; 67.6% white). Comorbid OSA and insomnia was defined as Apnea-Hypopnea Index = 5 events per hour and Insomnia Severity Index = 10. Outcome variables included mood, diabetes-related distress, and functional outcomes. RESULTS: Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all s < .05). Insomnia severity was associated with worse mood ( = 2.59, < .001) and diabetes-related distress ( = 1.40, < .001) and lower functional outcome ( = -0.22, < .001). Older age was associated with lower diabetes-related distress ( = -0.44, = .040). CONCLUSION: Older age was a protective factor of mood disturbance, diabetes-related distress, and functional impairment in adults with T2DM and comorbid OSA and insomnia. Insomnia severity was associated with greater mood disturbance, diabetes-related distress, and functional impairment when OSA and insomnia coexist. The results suggest that diabetes care and education specialists should assess patients for impaired sleep.